Korean J Radiol.  2007 Oct;8(5):448-451. 10.3348/kjr.2007.8.5.448.

Aspergillus Spondylitis involving the Cervico-Thoraco-Lumbar Spine in an Immunocompromised Patient: a Case Report

• Son JM
• Jee WH
• Jung CK
• Kim SI
• Ha KY

• KMID: 1734295
• DOI: http://doi.org/10.3348/kjr.2007.8.5.448

Abstract

Aspergillosis is a rare cause of spondylitis. Moreover, early diagnosis by MR imaging and adequate treatment can prevent the serious complications of fungal infection. To our knowledge, the MR findings of multilevel aspergillus spondylitis in the cervico-thoraco-lumbar spine have not been previously described. Here, we report the MR findings of aspergillus spondylitis involving the cervical, thoracic, and lumbar spine in a liver transplant recipient.

Keyword

Aspergillosis; Spine, infection; Magnetic resonance (MR)

MeSH Terms

Aspergillosis/*diagnosis
Aspergillus/isolation & purification
Bone Transplantation
Cervical Vertebrae/microbiology/pathology/surgery
Humans
*Immunocompromised Host
Liver Transplantation
Lumbar Vertebrae/microbiology/pathology/surgery
Magnetic Resonance Imaging
Male
Middle Aged
Postoperative Complications/diagnosis/microbiology/surgery
Rare Diseases
Spondylitis/*microbiology/surgery
Thoracic Vertebrae/microbiology/pathology/surgery

Figure

• 

  Fig. 1 A 46-year-old man with aspergillus spondylitis. A, B. MR image of the lumbar spine showing band-like or diffuse hypointense signals (arrows) in vertebral bodies L2-L5 on T1-weighted images (A), whereas these lesions were isointense to slightly hyperintense (arrows) on T2-weighted images (B). Some hypointense signals with intranuclear cleft preservation were evident in L2-3 and L4-5 discs. However, an absence of disc hyperintensity and intranuclear cleft loss were observed in the L3-4 disc. Endplate irregularities were evident in the involved spine, and disc space narrowing was observed in L3-4 and L4-5. C. Band-like or diffuse enhancement (arrows) was observed in involved vertebral bodies with epidural abscesses (arrowheads) on sagittal fat-suppressed contrast-enhanced T1-weighted image. D. Axial fat-suppressed contrast-enhanced T1-weighted image showing relatively well-defined paraspinal abnormal enhancement (arrows). E, F. MR image of cervical spine showing diffuse hypointense signals (arrows) in C4-5 and T2-4 vertebral bodies on T1-weighted images (E). The lesions were isointense to slightly hyperintense (arrows) on T2-weighted images (F). Increased disc signal and loss of intranuclear cleft were observed in C4-5 and T2-4 discs. Endplate irregularities and disc space narrowing were seen in involved spine. G. Diffuse enhancement was seen in involved vertebral bodies with paraspinal (arrows) and epidural masses (arrowheads) on sagittal fat-suppressed contrast-enhanced T1-weighted images. H. Pathological examination of an intervertebral disc revealed acute inflammation, necrosis and portions of the tissue being invaded by septate hyphae (Hematoxylin & Eosin staining, ×200). I. Branching septate hyphae were uniform in width and disposed mainly at acute angles (diastase periodic acid Schiff, ×400).

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