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Successful Management of Spondylodiscitis Caused by Aspergillus nidulans: A Case Report and Literature Review

Summary

A 59-year-old patient with lymphoma developed a serious fungal spine infection caused by Aspergillus nidulans, a rare mold. The infection was diagnosed using imaging, fungal cultures, and laboratory testing. The patient was successfully treated with a 6-month course of the antifungal drug voriconazole without requiring surgery. This case is notable because it represents the first successful treatment of this extremely rare infection in a cancer patient.

Background

Aspergillus nidulans is a saprophytic fungus that can cause various infections in immunocompromised patients, though osteoarticular infections are rare. Spondylodiscitis caused by A. nidulans is an extremely uncommon condition affecting immunocompromised individuals.

Objective

To report a case of spondylodiscitis caused by A. nidulans in a 59-year-old immunocompromised patient with lymphoma and splenectomy, and to review the distinctive features of previously published cases.

Results

A. nidulans was successfully isolated and identified from disc biopsies with molecular confirmation showing 99.2% sequence identity. The strain was susceptible to itraconazole and isavuconazole, and the patient was treated with voriconazole for 6 months with clinical improvement at 3 months and radiologic regression at 4 months. No surgical intervention was required.

Conclusion

This case represents the first reported spondylodiscitis caused by A. nidulans in an immunocompromised patient with hematologic malignancy other than chronic granulomatous disease to achieve successful outcome without surgical debridement. Prompt antifungal therapy and comprehensive diagnostic approaches are essential for managing this rare infection.
  • Published in:Journal of Fungi (Basel),
  • Study Type:Case Report and Literature Review,
  • Source: PMID: 40422695, DOI: 10.3390/jof11050361
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