文献类型：期刊文献

英文题名：Scedosporium apiospermum infection of the lumbar vertebrae: A case report

作者：Shi, Xue-Wen[1,2];Li, Sheng-Tang[1,3];Lou, Jin-Peng[1,2];Xu, Bo[1,3];Wang, Jian[1,4];Wang, Xin[1,2];Liu, Hua[1];Li, Song-Kai[1];Zhen, Ping[1];Zhang, Tao[1]

第一作者：Shi, Xue-Wen

通信作者：Zhang, T[1]

机构：[1]940 Hosp Joint Logist Support Force Chinese Peopl, Orthopaed Ctr, 333 Nanbinhe Rd, Lanzhou 730050, Gansu, Peoples R China;[2]Ningxia Med Univ, Orthopaed Ctr, Clin Med Coll, Yinchuan 750000, Ningxia, Peoples R China;[3]Lanzhou Univ, Orthopaed Ctr, Clin Med Coll 2, Lanzhou 730000, Gansu, Peoples R China;[4]Gansu Univ Tradit Chinese Med, Orthopaed Ctr, Clin Med Coll, Lanzhou 730000, Gansu, Peoples R China

第一机构：940 Hosp Joint Logist Support Force Chinese Peopl, Orthopaed Ctr, 333 Nanbinhe Rd, Lanzhou 730050, Gansu, Peoples R China

通信机构：[1]corresponding author), 940 Hosp Joint Logist Support Force Chinese Peopl, Orthopaed Ctr, 333 Nanbinhe Rd, Lanzhou 730050, Gansu, Peoples R China.

年份：2022

卷号：10

期号：10

起止页码：3251

外文期刊名：WORLD JOURNAL OF CLINICAL CASES

收录：;WOS:【SCI-EXPANDED(收录号:WOS:000799940600029)】；

基金：Supported by Chinese People's Liberation Army Medical Technology Youth Training Program, No. 20QNPY071.

语种：英文

外文关键词：Scedosporium apiospermum; Lumbar vertebrae; Fungal infection; Treatment; Voriconazole; Case report

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 degrees backward extension, right and left lateral curvature, and rotational mobility were about 10 degrees tenderness of the spinous processes of the lumbar 3-5 vertebrae was evident, and the muscle strength of both lower limbs was grade IV. 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 follow-up, 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 immunocompetent individuals with no history of near drowning. Voriconazole is effective for the treatment of S. apiospermum infection of the lumbar vertebrae for which it is suitable as the first-line therapy.