title: Aspergillus spondylodiscitis after multivisceral transplantation.
abstract: 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.
authors.affiliation: Department of General, Visceral and Transplant Surgery, Charité-Universitaetsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany.
authors.forename: Undine A
authors.initials: UA
authors.lastname: Gerlach
authors.forename: Sven
authors.initials: S
authors.lastname: Kohler
authors.forename: Igor M
authors.initials: IM
authors.lastname: Sauer
authors.forename: Dinah
authors.initials: D
authors.lastname: Joerres
authors.forename: Frank
authors.initials: F
authors.lastname: Kandziora
authors.forename: Peter
authors.initials: P
authors.lastname: Neuhaus
authors.forename: Johann
authors.initials: J
authors.lastname: Pratschke
authors.forename: Andreas
authors.initials: A
authors.lastname: Pascher
mesh_terms: 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
chemical_list: D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole; D016559:Tacrolimus