Diagnosis and management of lumbar Aspergillus spp. discospondylitis using intraoperative cytology and external stabilization in a dog with disseminated infection

BACKGROUND: Discospondylitis is an infection of the intervertebral disc and adjacent vertebral endplates. The infectious agent is most commonly a bacterial organism and fungal causes are uncommon. CASE DESCRIPTION: A 1.5-year-old female entire pug was referred with a 6-week history of right head tilt and progressive non-ambulatory paraparesis. On neurological examination, right facial paralysis and mid and caudal lumbar pain were also detected. Magnetic resonance imaging and computed tomography of the head and spine were performed 3 weeks apart. Findings were consistent with osteolysis of the petrous temporal bone and L2-L3 and L5-L6 vertebral subluxation caused by discospondylitis and osteomyelitis. Disseminated aspergillosis was diagnosed following biopsy and stabilization using an external skeletal spinal fixator. Voriconazol was administered as a medical treatment after surgery. The dog died 3 months later without failure of the construct. CONCLUSION: To the authors’ knowledge, this is the first report using an external fixator for fungal lumbar discospondylitis. The use of an external skeletal spinal fixator should be considered when choosing the surgical technique.