title: Aspergillus meningitis and discitis from low-back procedures in an immunocompetent patient.
abstract: We present a case of an immunocompetent patient who developed Aspergillus meningitis, subsequent to discitis, presumed to be from an epidural steroid injection. Magnetic resonance imaging (MRI) of the lumbar spine confirmed the diagnosis of discitis. Fluoroscopic-guided aspiration of the disc showed growth of Aspergillus fumigatus. MRI of the brain revealed involvement of the right third cranial nerve. Repeat MRIs demonstrated multiple leptomeningeal masses consistent with granulomatous meningitis. Meningitis is a rare complication of discitis, discogram, or epidural steroid injection. Aspergillus usually only infects immunocompromised patients, but rarely can affect immunocompetent patients.
authors.affiliation: Department of Radiology/Neuroradiology, University of Minnesota Medical Center, Minneapolis, Minnesota, USA.
authors.forename: A B Larson
authors.initials: AB
authors.lastname: Kolbe
authors.forename: A M
authors.initials: AM
authors.lastname: McKinney
authors.forename: A Tuba Karagulle
authors.initials: AT
authors.lastname: Kendi
authors.forename: D
authors.initials: D
authors.lastname: Misselt
mesh_terms: D001228:Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D001232:Aspergillus fumigatus / Q000276:immunology / Q000302:isolation & purification; D001921:Brain / Q000473:pathology; D015299:Discitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007121:Immunocompetence; D007268:Injections, Epidural / Q000009:adverse effects; D008161:Lumbosacral Region / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D016921:Meningitis, Fungal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications; D010359:Patient Readmission; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D035583:Rare Diseases