Surgery for blastomycosis of the spine.
Am J Orthop (Belle Mead NJ)
; 43(11): E266-71, 2014 Nov.
Article
de En
| MEDLINE
| ID: mdl-25379755
ABSTRACT
Blastomycosis is a rare fungal infection that primarily produces acute lung infections but may disseminate to multiple sites, including the spine. Once vertebral involvement occurs, an untreated infection may result in vertebral body destruction and paraspinal and epidural abscess formation followed by neurologic injury and loss of structural integrity of the spine. We report the case of a 30-year-old man who had pulmonary blastomycosis (treated with oral itraconazole for 6 months) and presented with a 2-month history of mild thoracolumbar back pain and numbness and tingling in the lower extremities, but no neurologic deficits. Imaging revealed a destructive lesion of T11 with an extensive paravertebral and retropleural abscess tracking a spinal level above and below with extension into the spinal canal. The patient underwent incision and drainage, culture procurement and corpectomy of T11 with autogenous rib graft in a titanium cage, and, 1 week later, posterior fusion and instrumentation. Cultures were positive for Blastomycosis dermatitidis. Oral itraconazole was continued. Blastomycosis that disseminates to the spine may cause serious neurologic and structural complications. In most cases, long-term use of antifungal medication eradicates the infection. Should medical treatment fail, however, surgery is a useful option.
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Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Ostéomyélite
/
Syndrome de compression médullaire
/
Vertèbres thoraciques
/
Blastomycose
/
Mycoses pulmonaires
Limites:
Adult
/
Humans
/
Male
Langue:
En
Journal:
Am J Orthop (Belle Mead NJ)
Sujet du journal:
ORTOPEDIA
Année:
2014
Type de document:
Article