Aspergillus terreus Osteomyelitis

Seligsohn, Robert; Rippon, John W.; Lerner, Stephen A.

doi:10.1001/archinte.1977.03630190072018

Cited by 47 publications

(13 citation statements)

References 29 publications

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“…5,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] The Medline Õ /PubMed Õ databases were searched using the key words: 'Aspergillus, vertebral osteomyelitis' and 'fungal granulomatous inflammation, vertebral osteomyelitis'. Vertebral osteomyelitis caused by A. nidulans occurs most frequently in immunocompromised patients and is rare in hosts with an uncompromised immunological status.…”

Section: Discussionmentioning

confidence: 99%

Vertebral osteomyelitis and epidural abscess due toAspergillus nidulansresulting in spinal cord compression: Case report and literature review

et al. 2013

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Vertebral osteomyelitis caused by Aspergillus nidulans is rare and usually affects immunocompromised patients. This report presents a case of thoracic vertebral osteomyelitis with epidural abscesses due to A. nidulans in a 40-year-old immunocompetent female who presented with back pain, numbness and weakness of both lower limbs. Magnetic resonance imaging demonstrated osteomyelitis involving the thoracic (T)1-T3 vertebral bodies with epidural abscesses, resulting in spinal compression. The patient underwent a decompression laminectomy of T1-T3 and debridement of the thoracic epidural inflammatory granuloma. Histopathology revealed fungal granulomatous inflammation. The patient received 6 mg/kg voriconazole every 12 h (loading dose on day 1) followed by 4 mg/kg voriconazole twice daily for 1 month, administered intravenously. The patient returned with recurrent back pain 16 months after initial presentation. A. nidulans was identified by fungal culture and polymerase chain reaction. The patient showed no evidence of recurrence 1 year after a 6-month course of oral voriconazole. The key to the effective treatment of Aspergillus osteomyelitis is not to excise the abscess, but to administer systemic antifungal drug therapy.

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Section: Discussionmentioning

confidence: 99%

Vertebral osteomyelitis and epidural abscess due toAspergillus nidulansresulting in spinal cord compression: Case report and literature review

et al. 2013

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“…A. fumigatus and A. flavus are the most frequent etiologic agents of pulmonary and systemic aspergillosis, whereas infection with A. terreus is rarely reported (3). So far, A. terreus has been incriminated as a causative agent in allergic bronchopulmonary aspergillosis (12,13), invasive aspergillosis (4,9,10,30), cardiac infections (6,22,23), osteomyelitis (25), and septic arthritis (27). Cases of pulmonary aspergilloma due to A. terreus have rarely been reported (12).…”

Section: Case Reportmentioning

confidence: 99%

Bilateral Pulmonary Aspergilloma Caused by an Atypical Isolate of Aspergillus terreus

Khan

Kortom²,

Marouf

et al. 2000

J Clin Microbiol

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A case of bilateral pulmonary aspergilloma caused by an atypical isolate of Aspergillus terreus is described. The diagnosis was established by the presence of septate, dichotomously branched fungal elements in freshly collected bronchoalveolar lavage and sputum specimens and by repeated isolation of the fungus in culture. Specific precipitating antibodies against the A. terreus isolate were demonstrated in the patient's serum. The isolate was atypical as it failed to produce fruiting structures on routine mycological media, but it did so on extended incubation on potato flake agar and produced globose, relatively heavy-walled, hyaline accessory conidia (formerly termed aleurioconidia) on both vegetative and aerial mycelia. Also, it produced an intense yellow diffusing pigment in the medium. The report underscores the increasing importance of A. terreus in the etiology of pulmonary aspergillosis. It is suggested that A. terreus antigen be included in the battery of serodiagnostic reagents to facilitate the early diagnosis of infections caused by this species.

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“…To the best of our knowledge, only seven cases of spondylodiscitis caused by A. terreus have been reported previously in humans. In two cases reported by Seligsohn et al [6] and Brown et al . [7], respectively, the infection may have resulted from hematogenous dissemination secondary to intravenous drug injection.…”

Section: Discussionmentioning

confidence: 99%

Aspergillus terreus spondylodiscitis following an abdominal stab wound: a case report

et al. 2019

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Background Aspergillus terreus , a saprophytic fungus, is recognized as an emerging pathogen in various infections in humans. However, bone and joint involvement is uncommon. To the best of our knowledge, only seven cases of spondylodiscitis caused by Aspergillus terreus have been reported previously in humans. We report a case of a patient with Aspergillus terreus spondylodiscitis following an abdominal stab wound. Case presentation A 74-year-old Japanese man with no particular medical history fell from a ladder and sustained a left abdominal stab wound from an L-shaped metal peg. Computed tomography showed the trace of the L-shaped metal peg from the left abdomen to the left rib and left kidney. The scan also showed an anterolateral bone avulsion of the left side of the T12 vertebral body, as well as fractures of the L1 left transverse process and the left 10th–12th ribs. He was hospitalized and treated with conservative therapy for 6 weeks. He was readmitted to the hospital with complaints of sudden back pain, numbness of both legs, and inability to walk 13 weeks after the fall. Magnetic resonance imaging findings were typical of spondylodiscitis. Gadolinium-enhanced T1-weighted magnetic resonance imaging indicated increased signal intensity at T11–T12 vertebral bodies and severe cord compression and epidural abscess at T11–T12 associated with infiltration of soft paravertebral tissues. On the seventh day after admission, he underwent partial laminectomy at T11 and posterior fusion at T9 to L2. The result of his blood culture was negative, but Aspergillus terreus was isolated from the material of T11–T12 intervertebral disc and vertebral bodies. His Aspergillus antigen was positive in a blood examination. Histological examination showed chronic suppurative osteomyelitis. On the 35th day after admission, he underwent anterior fusion at T11 and T12 with a rib bone graft. For 5 months, voriconazole was administered, and he wore a rigid corset. Posterior partial laminectomy at T11 and anterior fusion at T11 and T12 resulted in a good clinical course. The patient’s neurological dysfunction was completely recovered, and his back pain disappeared. Two years after the operation, computed tomography was performed and showed bone fusion at T11 and T12. Magnetic resonance imaging revealed no evidence of increased signal intensity at T11–T12 vertebral bodies and severe cord compression and epidural abscess at T11–T12. Conclusions To our knowledge, this is the first report of spondylodiscitis caused by Aspergillus terreus after an abdominal penetrating injury. The histological finding of chronic suppurative osteomyelitis and the radiological findings strongly suggested direct inoculation of Aspergillus terreus .

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Aspergillus terreus Osteomyelitis

Cited by 47 publications

References 29 publications

Vertebral osteomyelitis and epidural abscess due toAspergillus nidulansresulting in spinal cord compression: Case report and literature review

Vertebral osteomyelitis and epidural abscess due toAspergillus nidulansresulting in spinal cord compression: Case report and literature review

Bilateral Pulmonary Aspergilloma Caused by an Atypical Isolate of Aspergillus terreus

Aspergillus terreus spondylodiscitis following an abdominal stab wound: a case report

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