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Fungal spondylodiscitis: imaging findings and brief review of the literature
  1. Luca Cevolani1,
  2. Giancarlo Facchini2,
  3. Stefano Pasini1 and
  4. Giuseppe Bianchi1
  1. 1 Clinica III, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
  2. 2 Department of Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
  1. Correspondence to Dr Luca Cevolani; luca.cevolani{at}gmail.com

Abstract

A 57-year-old man was admitted to our department reporting persistent low back and leg pain; this patient had undergone chemotherapy 1 year earlier for acute myeloid leukaemia (AML). During chemotherapy, he exhibited bilateral pneumonia due to Candida tropicalis, which was treated by specific antibiotic therapy, and septicaemia by Enterococcus faecalis. MRI showed the presence of spondylodiscitis. A CT-guided needle biopsy was performed and the culture from the excised material tested positive for C. tropicalis. We report a rare case of spondylodiscitis by C. tropicalis in a patient treated for AML, which, in turn, was followed by sepsis from E. faecalis and C. tropicalis. Without adequate treatment, the disease is progressive, and leads to vertebral destruction with secondary kyphosis and neural or spinal cord compression. Although MRI has high sensitivity in the diagnosis of spondylodiscitis, open or needle biopsy allows to identify the aetiology.

  • infections
  • malignant disease and immunosuppression
  • orthopaedics
  • radiology

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Footnotes

  • Contributors Study conception and design: LC. Acquisition of data: Not applicable. Analysis and interpretation of data: Not applicable. Drafting of manuscript: LC and SP. Critical revision: GF and GB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

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