Neurospine.
2021 Mar;18(1):23-33. 10.14245/ns.2040338.169.
Spontaneous Vertebral Aspergillosis, the State of Art: A Systematic Literature Review
- Perna A
1 - Ricciardi L2,3
- Fantoni M4,5
- Taccari F5
- Torelli R4
- Santagada DA1,6
- Fumo C1
- Tamburrelli FC1,6
- Proietti L1,6
- Affiliations
-
- 1UOC Chirurgia Vertebrale, Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Rome, Italy
- 2UO di Neurochirurgia, Pia fondazione di Culto e Religione Cardinal G. Panico, Tricase, Italy
- 3UOC di Neurochirurgia, Azienda Ospedaliera Sant’Andrea, Dipartimento NESMOS, Facoltà di Medicina e Psicologia, Sapienza, Rome, Italy
- 4Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy.
- 5Dipartimento di Sicurezza e Bioetica, Università Cattolica S. Cuore, Rome, Italy
- 6Istituto di clinica ortopedica, Università Cattolica del Sacro Cuore, Rome, Italy
- KMID: 2514283
- DOI: http://doi.org/10.14245/ns.2040338.169
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.
