[Epidural aspergillosis secondary to lung aspergilloma despite long-term itraconazole treatment].
A 58-year-old man developed spinal cord compression at the T2-T3 level due to an Aspergillus epidural abscess. This presumably immunocompetent patient had been treated for two years by oral itraconazole (200 mg/day) for a lung aspergilloma that occurred seven years after removal of a lung adenocarcinoma. Surgical debridement was performed via a wide posterior approach associated with high-dose amphotericin B. Five months later, the patient's neurological deficit had not improved and the patient died from respiratory failure. Despite a long-term treatment with itraconazole, the infection spread locally from a lung aspergilloma to the epidural space.
Jeanrot
C
C
Service de Chirurgie Orthopédique et Traumatologique, Hôpital Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France.
Guigui
P
P
Groussard
O
O
Deburge
A
A
D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000150:complications* / Q000188:drug therapy; D001232:Aspergillus fumigatus; D020802:Epidural Abscess / Q000209:etiology*; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use*; D008172:Lung Diseases, Fungal / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D013904:Thoracic Vertebrae; D013997:Time Factors; D017211:Treatment Failure
D000935:Antifungal Agents; D017964:Itraconazole