'Fungal spondylodiscitis in a non-immunocompromised patient'

Abstract

Spondylodiscitis is an inflammatory disease, usually infectious, of one or more vertebral bodies and of corresponding intervertebral discs. The fungal aetiology is rare (less than 5% of cases), affecting mostly immunocompromised individuals. It is often a delayed diagnosis by the indolence of symptoms, presenting itself as a serious infection, which may result in important functional consequences. The authors present the case of a 75-year-old male, with constitutional complaints and intense back pain. Prior recent history of left hemicolectomy due to diverticulitis with multiple surgical complications, resulted in prolonged intensive care unit hospitalisation, and, later on, an episode of fungal endophthalmitis. The diagnosis of spondylodiscitis L5/S1 was performed by MRI. The patient underwent surgical disco-vertebral debridement and isolation of a Candida albicans was seen in the collected surgical material. No evidence of an immunossupressive status was found. Treatment was complemented with liposomal amphotericin B in the maximum recommended dose.

Quantitative B-lymphocyte deficiency and increased TCRγδ T-lymphocytes in acute infectious spondylodiscitis

“…In this prospective study, we evaluate B and T-lymphocyte subsets in patients with AIS at diagnosis and 3 months after antibacterial treatment. To our knowledge, there are no prior studies of the immune system in patients with AIS or osteomyelitis, although there are casuistic reports of rare cases leading to evaluation of immunologic status 11 – 13 and in chronic osteomyelitis, studies have dealt with the interaction between immunological cells, bone resorption and treatment effect 14 – 18 .…”

A toddler who refused to stand or walk: lumbar spondylodiscitis

“…As aforementioned in the background section we have used the definition of spondylodiscitis as an inflammatory disease involving one or more vertebral bodies and the corresponding intervertebral discs 1. However, in paediatrics spondylodiscitis is often just described as discitis (intervertebral disc infection) whereas an infection of the vertebrae is called vertebral osteomyelitis.…”

“…Of the blood tests, it is mainly the ESR that can be helpful; it is usually raised at the onset of the disease and it is useful for plotting the clinical course of the condition. However, white blood cell count and CRP are usually within normal limits and blood cultures are usually sterile 1 3 14…”

“…Spondylodiscitis is an inflammatory disease, usually infectious, of one or more vertebral bodies and of the corresponding intervertebral discs 1. In children the diagnosis can be a major challenge due to some of the following reasons.…”

Spinal Infections

“…Fungal infections of the spine are relatively uncommon (0.5%-1.6% 35 ). Most are seen in patients with diabetes or those who are inmunocompromised, including those with HIV, those who have undergone organ transplantation, and those undergoing chemotherapy.…”