Aspergillus fumigatus spondylitis in an immunocompetent patient with annular high signal around the intervertebral disks: a case report and literature review

Aspergillus fumigatus spondylitis is a rare fungal infection, primarily occurring in immunocompromised patients, although cases in immunocompetent individuals have also been reported. While Aspergillus fumigatus is commonly associated with pulmonary infections, it can also cause spondylitis. Patient...

Full description

Saved in:
Bibliographic Details
Main Authors: Zhihao Xu, Weijian Zhu, Sirui Zhou, Yuting Zhao, Qi Xiang, Yi Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2024.1532282/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849393309199368192
author Zhihao Xu
Weijian Zhu
Sirui Zhou
Yuting Zhao
Qi Xiang
Yi Zhang
author_facet Zhihao Xu
Weijian Zhu
Sirui Zhou
Yuting Zhao
Qi Xiang
Yi Zhang
author_sort Zhihao Xu
collection DOAJ
description Aspergillus fumigatus spondylitis is a rare fungal infection, primarily occurring in immunocompromised patients, although cases in immunocompetent individuals have also been reported. While Aspergillus fumigatus is commonly associated with pulmonary infections, it can also cause spondylitis. Patients typically present with back pain, limb numbness, and neurological compression symptoms. Imaging findings often show vertebral destruction, reduced disk height, and paraspinal abscesses, potentially accompanied by characteristic ring-enhancing lesions. MRI findings can help distinguish Aspergillus fumigatus spondylitis from other conditions such as tuberculous spondylitis. This case involves an immunocompetent patient with Aspergillus fumigatus spondylitis, whose non-specific clinical manifestations can easily be confused with other types of spinal infections, leading to a potential misdiagnosis. Diagnosis requires tissue biopsy and microbiological culture. Voriconazole is the first-line antifungal agent, and studies have shown that it improves patient response and survival rates. For patients with significant spinal compression or neurological symptoms, surgical intervention combined with antifungal treatment should be considered if antifungal therapy alone is ineffective. Although Aspergillus fumigatus spondylitis is rare, it can occur in immunocompetent individuals. Early diagnosis through imaging and biopsy is crucial, and a combination of surgery and antifungal therapy can help improve prognosis.
format Article
id doaj-art-dd04fd3f73e144a996facf686387b8db
institution Kabale University
issn 2296-858X
language English
publishDate 2025-01-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-dd04fd3f73e144a996facf686387b8db2025-08-20T03:40:28ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011110.3389/fmed.2024.15322821532282Aspergillus fumigatus spondylitis in an immunocompetent patient with annular high signal around the intervertebral disks: a case report and literature reviewZhihao Xu0Weijian Zhu1Sirui Zhou2Yuting Zhao3Qi Xiang4Yi Zhang5Department of Hepatobiliary Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, ChinaDepartment of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Respiratory, Li Yuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Clinical Laboratory, KadWise Co, Wuhan, ChinaDepartment of Cardiology, Xie he Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Orthopedics, Wuhan Tongji Aerospace City Hospital, Wuhan, ChinaAspergillus fumigatus spondylitis is a rare fungal infection, primarily occurring in immunocompromised patients, although cases in immunocompetent individuals have also been reported. While Aspergillus fumigatus is commonly associated with pulmonary infections, it can also cause spondylitis. Patients typically present with back pain, limb numbness, and neurological compression symptoms. Imaging findings often show vertebral destruction, reduced disk height, and paraspinal abscesses, potentially accompanied by characteristic ring-enhancing lesions. MRI findings can help distinguish Aspergillus fumigatus spondylitis from other conditions such as tuberculous spondylitis. This case involves an immunocompetent patient with Aspergillus fumigatus spondylitis, whose non-specific clinical manifestations can easily be confused with other types of spinal infections, leading to a potential misdiagnosis. Diagnosis requires tissue biopsy and microbiological culture. Voriconazole is the first-line antifungal agent, and studies have shown that it improves patient response and survival rates. For patients with significant spinal compression or neurological symptoms, surgical intervention combined with antifungal treatment should be considered if antifungal therapy alone is ineffective. Although Aspergillus fumigatus spondylitis is rare, it can occur in immunocompetent individuals. Early diagnosis through imaging and biopsy is crucial, and a combination of surgery and antifungal therapy can help improve prognosis.https://www.frontiersin.org/articles/10.3389/fmed.2024.1532282/fullAspergillus fumigatusAspergillusinfectious spondylitisimmunocompetentclinical features
spellingShingle Zhihao Xu
Weijian Zhu
Sirui Zhou
Yuting Zhao
Qi Xiang
Yi Zhang
Aspergillus fumigatus spondylitis in an immunocompetent patient with annular high signal around the intervertebral disks: a case report and literature review
Frontiers in Medicine
Aspergillus fumigatus
Aspergillus
infectious spondylitis
immunocompetent
clinical features
title Aspergillus fumigatus spondylitis in an immunocompetent patient with annular high signal around the intervertebral disks: a case report and literature review
title_full Aspergillus fumigatus spondylitis in an immunocompetent patient with annular high signal around the intervertebral disks: a case report and literature review
title_fullStr Aspergillus fumigatus spondylitis in an immunocompetent patient with annular high signal around the intervertebral disks: a case report and literature review
title_full_unstemmed Aspergillus fumigatus spondylitis in an immunocompetent patient with annular high signal around the intervertebral disks: a case report and literature review
title_short Aspergillus fumigatus spondylitis in an immunocompetent patient with annular high signal around the intervertebral disks: a case report and literature review
title_sort aspergillus fumigatus spondylitis in an immunocompetent patient with annular high signal around the intervertebral disks a case report and literature review
topic Aspergillus fumigatus
Aspergillus
infectious spondylitis
immunocompetent
clinical features
url https://www.frontiersin.org/articles/10.3389/fmed.2024.1532282/full
work_keys_str_mv AT zhihaoxu aspergillusfumigatusspondylitisinanimmunocompetentpatientwithannularhighsignalaroundtheintervertebraldisksacasereportandliteraturereview
AT weijianzhu aspergillusfumigatusspondylitisinanimmunocompetentpatientwithannularhighsignalaroundtheintervertebraldisksacasereportandliteraturereview
AT siruizhou aspergillusfumigatusspondylitisinanimmunocompetentpatientwithannularhighsignalaroundtheintervertebraldisksacasereportandliteraturereview
AT yutingzhao aspergillusfumigatusspondylitisinanimmunocompetentpatientwithannularhighsignalaroundtheintervertebraldisksacasereportandliteraturereview
AT qixiang aspergillusfumigatusspondylitisinanimmunocompetentpatientwithannularhighsignalaroundtheintervertebraldisksacasereportandliteraturereview
AT yizhang aspergillusfumigatusspondylitisinanimmunocompetentpatientwithannularhighsignalaroundtheintervertebraldisksacasereportandliteraturereview