Aspergillus spinal epidural abscess: A case report and review of the literature

Aspergillus spinal epidural abscess (ASEA) is a rare entity that may mimic Pott's paraplegia as it commonly affects immunocompromised patients. We present one institutional case of ASEA with concomitant review of the literature. A 58-year-old female presented with intermittent low back pain for...

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Autores principales: Rashid, Mohammad Humayun, Hossain, Mohammad Nazrul, Ahmed, Nazmin, Kazi, Raad, Ferini, Gianluca, Palmisciano, Paolo, Scalia, Gianluca, Umana, Giuseppe Emmanuele, Hoz, Samer S, Chaurasia, Bipin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9274668/
https://www.ncbi.nlm.nih.gov/pubmed/35837429
http://dx.doi.org/10.4103/jcvjs.jcvjs_35_22
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author Rashid, Mohammad Humayun
Hossain, Mohammad Nazrul
Ahmed, Nazmin
Kazi, Raad
Ferini, Gianluca
Palmisciano, Paolo
Scalia, Gianluca
Umana, Giuseppe Emmanuele
Hoz, Samer S
Chaurasia, Bipin
author_facet Rashid, Mohammad Humayun
Hossain, Mohammad Nazrul
Ahmed, Nazmin
Kazi, Raad
Ferini, Gianluca
Palmisciano, Paolo
Scalia, Gianluca
Umana, Giuseppe Emmanuele
Hoz, Samer S
Chaurasia, Bipin
author_sort Rashid, Mohammad Humayun
collection PubMed
description Aspergillus spinal epidural abscess (ASEA) is a rare entity that may mimic Pott's paraplegia as it commonly affects immunocompromised patients. We present one institutional case of ASEA with concomitant review of the literature. A 58-year-old female presented with intermittent low back pain for 10 years recently aggravated and with concurrent spastic paraparesis, fever, and weight loss. Emergent magnetic resonance imaging (MRI) showed T11–T12 epidural abscess with discitis and osteomyelitis. After empirical treatment with antibiotics, computed tomography-guided, percutaneous biopsy with drainage was performed, showing granulomatous tubercular-like collection. Antitubercular therapy was initiated, but after 1 month, the patient's condition deteriorated. Repeat MRI showed growth of the spinal epidural abscess with significant cord compression and vertebral osteomyelitis. T11–T12 laminectomy and tissue removal were performed with a posterior midline approach. Tissue histopathology showed necrotic debris colonies of Aspergillus spp. Antifungal therapy was started, and the patient rapidly improved. ASEA may mimic Pott's disease at imaging, leading to immediate start of antitubercular treatment without prior biopsy, leading to severe worsening of patients’ clinical status. Cases of ASEA should be considered at pretreatment planning, opting for biopsy confirmation before treatment initiation so to prevent the occurrence of fatal infection-related complications.
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spelling pubmed-92746682022-07-13 Aspergillus spinal epidural abscess: A case report and review of the literature Rashid, Mohammad Humayun Hossain, Mohammad Nazrul Ahmed, Nazmin Kazi, Raad Ferini, Gianluca Palmisciano, Paolo Scalia, Gianluca Umana, Giuseppe Emmanuele Hoz, Samer S Chaurasia, Bipin J Craniovertebr Junction Spine Case Report Aspergillus spinal epidural abscess (ASEA) is a rare entity that may mimic Pott's paraplegia as it commonly affects immunocompromised patients. We present one institutional case of ASEA with concomitant review of the literature. A 58-year-old female presented with intermittent low back pain for 10 years recently aggravated and with concurrent spastic paraparesis, fever, and weight loss. Emergent magnetic resonance imaging (MRI) showed T11–T12 epidural abscess with discitis and osteomyelitis. After empirical treatment with antibiotics, computed tomography-guided, percutaneous biopsy with drainage was performed, showing granulomatous tubercular-like collection. Antitubercular therapy was initiated, but after 1 month, the patient's condition deteriorated. Repeat MRI showed growth of the spinal epidural abscess with significant cord compression and vertebral osteomyelitis. T11–T12 laminectomy and tissue removal were performed with a posterior midline approach. Tissue histopathology showed necrotic debris colonies of Aspergillus spp. Antifungal therapy was started, and the patient rapidly improved. ASEA may mimic Pott's disease at imaging, leading to immediate start of antitubercular treatment without prior biopsy, leading to severe worsening of patients’ clinical status. Cases of ASEA should be considered at pretreatment planning, opting for biopsy confirmation before treatment initiation so to prevent the occurrence of fatal infection-related complications. Wolters Kluwer - Medknow 2022 2022-06-13 /pmc/articles/PMC9274668/ /pubmed/35837429 http://dx.doi.org/10.4103/jcvjs.jcvjs_35_22 Text en Copyright: © 2022 Journal of Craniovertebral Junction and Spine https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Rashid, Mohammad Humayun
Hossain, Mohammad Nazrul
Ahmed, Nazmin
Kazi, Raad
Ferini, Gianluca
Palmisciano, Paolo
Scalia, Gianluca
Umana, Giuseppe Emmanuele
Hoz, Samer S
Chaurasia, Bipin
Aspergillus spinal epidural abscess: A case report and review of the literature
title Aspergillus spinal epidural abscess: A case report and review of the literature
title_full Aspergillus spinal epidural abscess: A case report and review of the literature
title_fullStr Aspergillus spinal epidural abscess: A case report and review of the literature
title_full_unstemmed Aspergillus spinal epidural abscess: A case report and review of the literature
title_short Aspergillus spinal epidural abscess: A case report and review of the literature
title_sort aspergillus spinal epidural abscess: a case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9274668/
https://www.ncbi.nlm.nih.gov/pubmed/35837429
http://dx.doi.org/10.4103/jcvjs.jcvjs_35_22
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