Spinal aspergillosis: a rare clinical case and a review of the literature
Objective. To analyze long-term results of treatment of a patient with recurrent lumbar aspergillosis and to systematize the literature data. Material and Methods. Long-term follow-up results of treatment of recurrent Aspergillus spondylitis in a 48-year-old patient who underwent primary surgery fo...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"
2023-06-01
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| Series: | Хирургия позвоночника |
| Subjects: | |
| Online Access: | https://www.spinesurgery.ru/jour/article/view/2020/2004 |
| _version_ | 1827889051418492928 |
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| author | Denis G. Naumov Arkady A. Vishnevsky Andrey A. Karpushin Mikhail M. Shchelkunov Sergey G. Tkach |
| author_facet | Denis G. Naumov Arkady A. Vishnevsky Andrey A. Karpushin Mikhail M. Shchelkunov Sergey G. Tkach |
| author_sort | Denis G. Naumov |
| collection | DOAJ |
| description | Objective. To analyze long-term results of treatment of a patient with recurrent lumbar aspergillosis and to systematize the literature data.
Material and Methods. Long-term follow-up results of treatment of recurrent Aspergillus spondylitis in a 48-year-old patient who underwent primary surgery for reconstruction of the anterior spinal column through the anterior approach were studied. Literature data on the treatment of spinal aspergillosis from 2000 to 2022 were systematized.
Results. The key method for the etiological verification of spinal aspergillosis is percutaneous bone biopsy from the lesion, followed by histological and bacteriological examination of the material. Isolated anterior spinal column reconstruction through the anterior approach ensures the achievement of local control of the infection process, but a short course of antimycotic chemotherapy after surgery is a factor of disease recurrence. The optimal duration of antimycotic chemotherapy in the postoperative period is at least 3 months, with voricon-
azole being the drug of choice.
Conclusion. Spondylitis caused by Aspergillus spp. is a special form of inflammatory spine disease requiring obligatory percutaneous bone biopsy for etiological verification. A multidisciplinary therapeutic approach including a course of conservative antimycotic therapy for at least 3 months, surgical debridement and reconstruction of the affected spinal motion segments provide the best clinical results. |
| first_indexed | 2024-03-12T20:49:37Z |
| format | Article |
| id | doaj.art-cfabef155ab6444f8ebedc82b403603e |
| institution | Directory Open Access Journal |
| issn | 1810-8997 2313-1497 |
| language | English |
| last_indexed | 2024-03-12T20:49:37Z |
| publishDate | 2023-06-01 |
| publisher | Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan" |
| record_format | Article |
| series | Хирургия позвоночника |
| spelling | doaj.art-cfabef155ab6444f8ebedc82b403603e2023-08-01T06:24:29ZengMinistry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"Хирургия позвоночника1810-89972313-14972023-06-01202657210.14531/ss2023.2.65-72Spinal aspergillosis: a rare clinical case and a review of the literatureDenis G. Naumov0https://orcid.org/0000-0002-9892-6260Arkady A. Vishnevsky1https://orcid.org/0000-0002-9186-6461Andrey A. Karpushin2https://orcid.org/0000-0002-7178-3861Mikhail M. Shchelkunov3https://orcid.org/0000-0002-6305-6023Sergey G. Tkach4https://orcid.org/0000-0001-7135-7312St. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, Russia; St. Petersburg State University, St. Petersburg, RussiaSt. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, RussiaSt. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, RussiaSt. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, RussiaSt. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, RussiaObjective. To analyze long-term results of treatment of a patient with recurrent lumbar aspergillosis and to systematize the literature data. Material and Methods. Long-term follow-up results of treatment of recurrent Aspergillus spondylitis in a 48-year-old patient who underwent primary surgery for reconstruction of the anterior spinal column through the anterior approach were studied. Literature data on the treatment of spinal aspergillosis from 2000 to 2022 were systematized. Results. The key method for the etiological verification of spinal aspergillosis is percutaneous bone biopsy from the lesion, followed by histological and bacteriological examination of the material. Isolated anterior spinal column reconstruction through the anterior approach ensures the achievement of local control of the infection process, but a short course of antimycotic chemotherapy after surgery is a factor of disease recurrence. The optimal duration of antimycotic chemotherapy in the postoperative period is at least 3 months, with voricon- azole being the drug of choice. Conclusion. Spondylitis caused by Aspergillus spp. is a special form of inflammatory spine disease requiring obligatory percutaneous bone biopsy for etiological verification. A multidisciplinary therapeutic approach including a course of conservative antimycotic therapy for at least 3 months, surgical debridement and reconstruction of the affected spinal motion segments provide the best clinical results.https://www.spinesurgery.ru/jour/article/view/2020/2004infectious spondylitisspinal aspergillosisdifferential diagnosisvoriconazolerevision surgery |
| spellingShingle | Denis G. Naumov Arkady A. Vishnevsky Andrey A. Karpushin Mikhail M. Shchelkunov Sergey G. Tkach Spinal aspergillosis: a rare clinical case and a review of the literature Хирургия позвоночника infectious spondylitis spinal aspergillosis differential diagnosis voriconazole revision surgery |
| title | Spinal aspergillosis: a rare clinical case and a review of the literature |
| title_full | Spinal aspergillosis: a rare clinical case and a review of the literature |
| title_fullStr | Spinal aspergillosis: a rare clinical case and a review of the literature |
| title_full_unstemmed | Spinal aspergillosis: a rare clinical case and a review of the literature |
| title_short | Spinal aspergillosis: a rare clinical case and a review of the literature |
| title_sort | spinal aspergillosis a rare clinical case and a review of the literature |
| topic | infectious spondylitis spinal aspergillosis differential diagnosis voriconazole revision surgery |
| url | https://www.spinesurgery.ru/jour/article/view/2020/2004 |
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