Iatrogenic Aspergillus Spondylitis after Posterior Instrumentation: A Case Report / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: This case report presents a rare case of Aspergillus osteomyelitis of the vertebra in an immunocompetent host. OBJECTIVES: To discuss the iatrogenic Aspergillus spondylitis after posterior instrumentation in an immunocompetent patient and review the pertinent literatures. SUMMARY OF BACKGROUND DATA Aspergillus spondylitis is very rare especially in immunocompetent host. Treatment requires early debridement and continuous medication with antifungal drugs. RESULT: This report discusses a case that occured in an immunocompetent 60 year-old woman who had posterolateral fusion with posterior instrumentation for T12 burst fracture. After a few months of operation, she complained chronic back pain and progressive neurologic compromise. The MR imaging showed an epidural mass compressing the spinal cord, so hardware removal and curettage was done at neurosurgical department. Her symptoms were not improved after hardware removal, so anterior decompression and fusion was done again. The biopsy of the epidural mass showed septated hyphae which is the characteristic of Aspergillosis. With aggressive surgical debridement and continuous treatment with amphotericin B, follow-up examination at postoperative 2 years showed neurologic improvement about 2 grades by Frankel classification.