Aspergillus fumigatus spondylodiscitis with bilateral psoas abscess in a renal transplant patient with pulmonary tuberculosis : A rare case report

  • Authors

    • Ravikumar Tv MS Ramaiah Medical College , Bangalore,India
    • Raghvendra Rao MS Ramaiah Medical College , Bangalore,India
    • Amit Grover MS Ramaiah Medical College , Bangalore,India
    • Daksh Gadi MS Ramaiah Medical College , Bangalore,India
    2015-06-19
    https://doi.org/10.14419/ijm.v3i2.4786
  • Aspergillus, Psoas Abscess, Spondylodiscitis, Tuberculosis.

  • Abstract

    Background: Aspergillus spondylodiscitis is increasingly described in immune-compromised patients. Its diagnosis is challenging and its delay results in high mortality and morbidity in view of its relative infrequency and the non- specific clinical signs and symptoms.

    Case report:We report a case of thoracic spondylodiscitis caused by Aspergillus fumigatus in a patient of renal transplantation and with proven pulmonary tuberculosis.

    Conclusion:We reiterate that transplantist and the treating physician should have high grade of suspicion for the invasive Aspergillosis even when the patient complains of vague non-specific back pain, and aggresively aim to rule out fungal infection. Early surgical debridement and antifungal therapy to be executedto prevent rapid progression of invasive aspergillosis and neurological damage.

  • References

    1. [1] Castelli C, Benazzo F, Minoli L, Marone P, Seghezzi R, Carlizzi CN. Aspergillus infection of the L3-L4 disc space in an immunosuppressed heart transplant patient. Spine (Phila Pa 1976). 1990; 15 (12):1369-1373. http://dx.doi.org/10.1097/00007632-199012000-00027.

      [2] ErsoyA.DizdarOA.OrucKocA,AkalinH.et al. Aspergillus Fumigatus Spondylodiskitis in Renal Transplant Patient: Voriconazole Experience ExpClinTransplant. 2011 Aug; 9 (4):265-9.

      [3] Gerlach UA, Kohler S, Sauer IM, et al. Aspergillus spondylodiscitis after multivisceral transplantation. Ann Transplant. 2009; 14 (4):52-57.

      [4] Hummel M, Schüler S, Weber U, et al. Aspergillosis with Aspergillus osteomyelitis and diskitis after heart transplantation: surgical and medical management. J Heart Lung Transplant. 1993; 12 (4):599-603.

      [5] Maschmeyer G, Haas A, Cornely OA. Invasive aspergillosis: epidemiology, diagnosis and management in immunocompromised patients. Drugs. 2007; 67 (11):1567-601. http://dx.doi.org/10.2165/00003495-200767110-00004.

      [6] Park SB, Kang MJ, Whang EA, Han SY, Kim HC. A case of fungal sepsis due to aspergillus spondydiscitis followed by cytomegalovirus infection in a renal transplant recipient. Transplant Proc. 2004; 36 (7):2154-2155. http://dx.doi.org/10.1016/j.transproceed.2004.08.049.

      [7] Rüping MJ, Vehreschild JJ, Cornely OA. Patients at high risk of invasive fungal infections: when and how to treat. Drugs. 2008; 68 (14):1941-62. http://dx.doi.org/10.2165/00003495-200868140-00002.

      [8] Salvalaggio PR, Bassetti M, Lorber MI, et al. Aspergillus vertebral osteomyelitis after simultaneous kidney-pancreas transplantation. Transpl Infect Dis. 2003; 5 (4):187-190. http://dx.doi.org/10.1111/j.1399-3062.2003.00030.x.

      [9] Tang TJ, Janssen HL, Van der Vlies CH, et al. Aspergillus osteomyelitis after liver transplantation: conservative or surgical treatment? Eur J GastroenterolHepatol. 2000; 12 (1):123-126. http://dx.doi.org/10.1097/00042737-200012010-00022.

      [10] Wéclawiak H, Garrouste C, Kamar N, et al. Aspergillus fumigatus-related spondylodiscitis in a heart transplant patient successfully treated with voriconazole. Transplant Proc. 2007; 39 (8):2627-2628. http://dx.doi.org/10.1016/j.transproceed.2007.08.014.

  • Downloads

  • How to Cite

    Tv, R., Rao, R., Grover, A., & Gadi, D. (2015). Aspergillus fumigatus spondylodiscitis with bilateral psoas abscess in a renal transplant patient with pulmonary tuberculosis : A rare case report. International Journal of Medicine, 3(2), 51-52. https://doi.org/10.14419/ijm.v3i2.4786

    Received date: 2015-05-17

    Accepted date: 2015-06-15

    Published date: 2015-06-19