Aspergillus spondylodiscitis after multivisceral transplantation.
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.


METHODS
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.
Gerlach
Undine A
UA
Department of General, Visceral and Transplant Surgery, Charité-Universitaetsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany.
Kohler
Sven
S
Sauer
Igor M
IM
Joerres
Dinah
D
Kandziora
Frank
F
Neuhaus
Peter
P
Pratschke
Johann
J
Pascher
Andreas
A
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001230:Aspergillus; D015299:Discitis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007403:Intervertebral Disc / Q000382:microbiology / Q000601:surgery; D017116:Low Back Pain / Q000209:etiology / Q000382:microbiology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000382:microbiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D016377:Organ Transplantation; D011183:Postoperative Complications; D055732:Pulmonary Aspergillosis / Q000150:complications*; D011743:Pyrimidines / Q000627:therapeutic use; D016559:Tacrolimus / Q000009:adverse effects*; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole; D016559:Tacrolimus