Scedosporium apiospermum infection of the lumbar vertebrae:A case report  

作　　者：Xue-Wen Shi Sheng-Tang Li Jin-Peng Lou Bo Xu Jian Wang Xin Wang Hua Liu Song-Kai Li Ping Zhen Tao Zhang 

机构地区：[1]Orthopaedic Centers,The 940^(th) Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army,Lanzhou 730050,Gansu Province,China [2]Orthopaedic Centers,The Clinical Medical College of Ningxia Medical University,Yinchuan 750000,Ningxia Hui Autonomous Region,China [3]Orthopaedic Centers,The Second Clinical Medical College of Lanzhou University,Lanzhou 730000,Gansu Province,China [4]Orthopaedic Centers,The Clinical Medical College of Gansu University of Traditional Chinese Medicine,Lanzhou 730000,Gansu Province,China

出　　处：《World Journal of Clinical Cases》2022年第10期3251-3260,共10页世界临床病例杂志

基　　金：Supported by Chinese People’s Liberation Army Medical Technology Youth Training Program,No. 20QNPY071

摘　　要：BACKGROUND Scedosporium apiospermum(S.apiospermum)is a clinically rare and aggressive fungus mainly found in contaminated water,wetlands,decaying plants,stagnant water,and potted plants in hospitals.The lung,bone,joint,eye,brain,skin,and other sites are easily infected,and there is a marked risk of misdiagnosis.There have been few case reports of infection by S.apiospermum of the lumbar vertebrae;most reports have focused on infection of the lung.CASE SUMMARY An otherwise healthy 60-year-old man presented with a 4-mo history of lumbosacral pain,stooping,and limited walking.The symptoms were significantly aggravated 10 d prior to hospitalization,and radiating pain in the back of his left lower leg developed,which was so severe that he could not walk.Movement of the lumbar spine was significantly limited,anterior flexion was about 30°;backward extension,right and left lateral curvature,and rotational mobility were about 10°;tenderness of the spinous processes of the lumbar 3-5 vertebrae was evident,and the muscle strength of both lower limbs was gradeⅣ.Imaging suggested bony destruction of the lumbar 3,4,and 5 vertebrae and sacral 1 vertebra;in addition,the corresponding intervertebral spaces were narrowed and the lumbar 5 vertebra was posteriorly displaced and unstable.Lumbar vertebral infection was also noted,and the possibility of lumbar tuberculosis was considered.We first performed surgical intervention on the lesioned lumbar vertebrae,cleared the infected lesion,and performed stable fixation of the lesioned vertebral body using a lumbar internal fixation device,which restored the stability of the lumbar vertebrae.Cytological and pathological examination of the lesioned tissue removed during surgery confirmed S.apiospermum infection of the lumbar vertebrae;on this basis,the patient was administered voriconazole.At the 6-mo followup,efficacy was significant,no drug-related side effects were observed,and imaging examination showed no evidence of recurrence.CONCLUSION S.apiospermum infection can occur in immu

关 键 词：Scedosporium apiospermum Lumbar vertebrae Fungal infection TREATMENT VORICONAZOLE Case report 

分 类 号：R519[医药卫生—内科学]