Fungal postoperative spondylodiscitis due to Scedosporium prolificans

Spine J. 2009 Sep;9(9):e1-7. doi: 10.1016/j.spinee.2009.03.012. Epub 2009 May 17.

Abstract

Background context: Postoperative fungal spondylodiscitis is a rare infectious disease.

Purpose: We report the first case of postoperative spondylodiscitis because of Scedosporium prolificans and review postoperative vertebral infection caused by fungi.

Study design/setting: Medline search.

Methods: Case report and literature review.

Results: On reviewing the cases of postoperative fungal spondylodiscitis reported so far in the literature, we found eight were caused by mold, and five by yeast. Clinically, the disease presents similar to postoperative vertebral osteomyelitis caused by bacteria, and a high clinical index of suspicion may be required to perform appropriate cultures to establish a diagnosis. Our review revealed a significant number of cases that were cured after surgical debridement and/or antifungal therapy.

Conclusions: On the basis of this limited assessment, it appears that the clinical course and prognosis of postoperative fungal spondylodiscitis is similar to that reported for postoperative pyogenic spondylodiscitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antifungal Agents / therapeutic use
  • Arthrodesis
  • Debridement
  • Discitis / microbiology*
  • Discitis / pathology
  • Discitis / surgery
  • Female
  • Humans
  • Intervertebral Disc Displacement / surgery
  • Magnetic Resonance Imaging
  • Middle Aged
  • Mycoses / etiology
  • Mycoses / microbiology*
  • Mycoses / pathology
  • Orthopedic Procedures / adverse effects
  • Postoperative Complications / microbiology*
  • Pyrimidines / therapeutic use
  • Scedosporium*
  • Triazoles / therapeutic use
  • Voriconazole

Substances

  • Anti-Bacterial Agents
  • Antifungal Agents
  • Pyrimidines
  • Triazoles
  • Voriconazole