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Spontaneous Vertebral Aspergillosis, the State of Art: A Systematic Literature Review

Neurospine 2021년 18권 1호 p.23 ~ 33
Perna Andrea, Ricciardi Luca, Fantoni Massimo, Taccari Francesco, Torelli Riccardo, Santagada Domenico Alessandro, Fumo Caterina, Tamburrelli Francesco Ciro, Proietti Luca,
소속 상세정보
 ( Perna Andrea ) - Fondazione Policlinico Universitario Agostino Gemelli - IRCCS UOC Chirurgia Vertebrale
 ( Ricciardi Luca ) - Pia fondazione di Culto e Religione Cardinal G. Panico UO di Neurochirurgia
 ( Fantoni Massimo ) - Fondazione Policlinico Universitario A. Gemelli IRCCS Dipartimento di Scienze di Laboratorio e Infettivologiche
 ( Taccari Francesco ) - Universita Cattolica S. Cuore Dipartimento di Sicurezza e Bioetica
 ( Torelli Riccardo ) - Fondazione Policlinico Universitario A. Gemelli IRCCS Dipartimento di Scienze di Laboratorio e Infettivologiche
 ( Santagada Domenico Alessandro ) - Fondazione Policlinico Universitario Agostino Gemelli - IRCCS UOC Chirurgia Vertebrale
 ( Fumo Caterina ) - Fondazione Policlinico Universitario Agostino Gemelli - IRCCS UOC Chirurgia Vertebrale
 ( Tamburrelli Francesco Ciro ) - Fondazione Policlinico Universitario Agostino Gemelli - IRCCS UOC Chirurgia Vertebrale
 ( Proietti Luca ) - Fondazione Policlinico Universitario Agostino Gemelli - IRCCS UOC Chirurgia Vertebrale

Abstract


Objective: Vertebral aspergillosis is quite rare conditions, often misdiagnosed, that requires long-term antibiotic therapy, and sometimes, surgical treatments. The present investigations were aimed to investigate the epidemiology, clinical-radiological aspects, treatment protocols, and outcomes of Aspergillus-mediated vertebral osteomyelitis.

Methods: A systematic review of the pertinent English literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed. The research was conducted on Cochrane library, MEDLINE, PubMed, and Scopus using as search-terms “Aspergillus,” “vertebral osteomyelitis,” “spondylodiscitis,” “spine infection.” A case of vertebral aspergillosis conservatively managed was also reported.

Results: Eighty-nine articles were included in our systematic review. Including the reported case, our analysis covered 112 cases of vertebral aspergillosis. Aspergillus fumigatus was isolated in 68 cases (61.2%), Aspergillus flavus in 14 (12.6%), Aspergillus terreus in 4 (3.6%), Aspergillus nidulans in 2 (1.8%). Seventy-three patients (65.7%) completely recovered at the last follow-up evaluation; in 7 patients (6.3%) radiological signs of chronic infection were reported, whereas 32 patients (28.8%) died during the follow-up.

Conclusion: This systematic review summarized the state of the art on vertebral aspergillosis, retrieving data on clinical features, diagnostic criteria and current limitations, treatment alternatives, and their outcomes.

키워드

Aspergillosis; Aspergillus flavus; Discitis; Osteomyelitis; Spinal osteomyelitis

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