title: Lumbar Aspergillus osteomyelitis mimicking pyogenic osteomyelitis in an immunocompetent adult.
abstract: Spinal Aspergillus osteomyelitis is rare and occurs mostly in immunocompromised patients, but especially very rare in immunocompetent adult. This report presents a case of lumbar vertebral osteomyelitis in immunocompetent adult. A 53-year-old male who had no significant medical history was admitted due to complaints of back pain radiating to the flank for the last 3 months, followed by a progressive motor weakness of both lower limbs. Lumbar magnetic resonance imaging (MRI) demonstrated osteomyelitis and diskitis, suspected to be a pyogenic condition rather than a tuberculosis infection. Despite antibiotic treatment for several weeks, the symptoms worsened, and finally, open surgery was performed. Surgical biopsy revealed an Aspergillus infection and medical treatment with amphotericin B was started. It can be diagnosed early through an MRI; biopsy is very important but difficult, and making the correct differential diagnosis is essential for avoiding unexpected complications. The authors report a case of lumbar Aspergillus osteomyelitis in an immunocompetent adult and reviewed previously described cases of spinal aspergillosis.
authors.affiliation: Department of Neurosurgery, Dankook University College of Medicine , Cheonan, Chungnam , Republic of Korea.
authors.forename: Kyeong-Wook
authors.initials: KW
authors.lastname: Yoon
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D001228:Aspergillosis / Q000175:diagnosis* / Q000276:immunology* / Q000473:pathology; D001230:Aspergillus / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D015299:Discitis / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D016867:Immunocompromised Host; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008161:Lumbosacral Region / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology
keywords: Aspergillus; lumbar spine; spine osteomyelitis