To report a rare case of fungal spondylodiscitis in a patient recovered from H7N9 virus infection and perform a literature review of the different characteristics of Candida and Aspergillus spondylodiscitis, we review...To report a rare case of fungal spondylodiscitis in a patient recovered from H7N9 virus infection and perform a literature review of the different characteristics of Candida and Aspergillus spondylodiscitis, we reviewed cases of spondylodiscitis caused by Candida and Aspergillus species. Data, including patients＇ information, patho- genic species, treatment strategy, outcomes, and relapses, were collected and summarized. The characteristics of Canclida and Aspergillus spondylodiscitis were compared to see if any differences in clinical features, management, or consequences could be detected. The subject of the case study was first misdiagnosed as having a vertebral tumor, and then, following open biopsy, was diagnosed as having fungal spondylodiscitis. The patient made a good recovery following radical debridement. Seventy-seven additional cases of Candida spondylodiscitis and 94 cases of Asper- gillus spondylodiscitis were identified in the literature. Patients with Candida spondylodiscitis tended to have a better outcome than patients with Aspergillus spondylodiscitis （cure rate 92.3% vs. 70.2%）. Candida was found more fre- quently （47.8%） than Aspergillus （26.7%） in blood cultures, while neurological deficits were observed more often in patients with Aspergillus spondylodiscitis （43.6% vs. 25.6%）. Candida spinal infections were more often treated by radical debridement （60.5% vs. 39.6%）. Patients with Candida spondylodiscitis have better outcomes, which may be associated with prompt recognition, radical surgical debridement, and azoles therapy. A good outcome can be ex- pected in fungal spondylodiscitis with appropriate operations and anti-fungal drugs.展开更多
基金Project supported by the Zhejiang Medical Technology and Education Foundation(No.2015107339),China
文摘To report a rare case of fungal spondylodiscitis in a patient recovered from H7N9 virus infection and perform a literature review of the different characteristics of Candida and Aspergillus spondylodiscitis, we reviewed cases of spondylodiscitis caused by Candida and Aspergillus species. Data, including patients＇ information, patho- genic species, treatment strategy, outcomes, and relapses, were collected and summarized. The characteristics of Canclida and Aspergillus spondylodiscitis were compared to see if any differences in clinical features, management, or consequences could be detected. The subject of the case study was first misdiagnosed as having a vertebral tumor, and then, following open biopsy, was diagnosed as having fungal spondylodiscitis. The patient made a good recovery following radical debridement. Seventy-seven additional cases of Candida spondylodiscitis and 94 cases of Asper- gillus spondylodiscitis were identified in the literature. Patients with Candida spondylodiscitis tended to have a better outcome than patients with Aspergillus spondylodiscitis （cure rate 92.3% vs. 70.2%）. Candida was found more fre- quently （47.8%） than Aspergillus （26.7%） in blood cultures, while neurological deficits were observed more often in patients with Aspergillus spondylodiscitis （43.6% vs. 25.6%）. Candida spinal infections were more often treated by radical debridement （60.5% vs. 39.6%）. Patients with Candida spondylodiscitis have better outcomes, which may be associated with prompt recognition, radical surgical debridement, and azoles therapy. A good outcome can be ex- pected in fungal spondylodiscitis with appropriate operations and anti-fungal drugs.
