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Aspergillus spondylodiscitis after multivisceral transplantation

Undine A. Gerlach, Sven Kohler, Igor M. Sauer, Dinah Joerres, Frank Kandziora, Peter Neuhaus, Johann Pratschke, Andreas Pascher

Ann Transplant 2009; 14(4): 52-57

ID: 880555

Published: 2009-12-09


Background:    Although spondylodiscitis is rare, it is increasingly described in patients with compromised immunity due to malignancy, chemotherapy or immunosuppression. Typical pathogens are staphylococcus aureus and enterobacteria; fungal spondylodiscitis is uncommon.
Case Report:    We present a case of aspergillus spondylodiscitis following pulmonary aspergillosis in a patient with multivisceral and kidney transplantation.
Due to irreversible disc destruction, surgical restoration by autologous iliac crest graft was required in addition to intravenous antifungal therapy, which consisted of voriconazole, caspofungin and liposomal amphotericin B.
Conclusions:    Aspergillus spondylodiscitis is a diagnostic and therapeutic challenge, a combination of surgical debridement and antifungal therapy is inevitable to prevent rapid progression of invasive aspergillosis and neurological damage.

Keywords: Aspergillus fumigatus, Immunosuppression, spinal surgery



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