Aspergillus vertebral osteomyelitis in chronic leukocyte leukemia patient diagnosed by a novel panfungal polymerase chain reaction method

Spine J. 2007 Sep-Oct;7(5):615-7. doi: 10.1016/j.spinee.2006.08.005. Epub 2007 Feb 12.

Abstract

Background context: Vertebral osteomyelitis and disciitis caused by Aspergillus spp is a rare event. Early diagnosis and early antifungal therapy are critical in improving the prognosis for these patients. The diagnosis of invasive fungal infections is, in many cases, not straightforward and requires invasive procedures so that histological examination and culture can be performed. Furthermore, current traditional microbiological tests (ie, cultures and stains) lack the sensitivity for diagnosis of invasive aspergillosis.

Purpose: To present a case of vertebral osteomyelitis caused by Aspergillus spp diagnosed using a novel polymerase chain reaction (PCR) assay.

Study design: Case report.

Methods: Aspergillus DNA was detected in DNA extracted from the necrotic bone tissue by using a "panfungal" PCR novel method.

Results: Treatment with voriconazole was started based on the diagnosis.

Conclusion: Using this novel technique enabled us to diagnose accurately an unusual bone pathogen that requires a unique treatment.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antifungal Agents / administration & dosage
  • Aspergillosis / complications*
  • Aspergillosis / drug therapy
  • Aspergillus / genetics
  • Aspergillus / isolation & purification*
  • Chronic Disease
  • DNA, Fungal / analysis
  • Fatal Outcome
  • Female
  • Humans
  • Leukemia / complications*
  • Opportunistic Infections / complications
  • Opportunistic Infections / microbiology
  • Osteomyelitis / complications
  • Osteomyelitis / microbiology*
  • Polymerase Chain Reaction / methods*
  • Pyrimidines / administration & dosage
  • Triazoles / administration & dosage
  • Voriconazole

Substances

  • Antifungal Agents
  • DNA, Fungal
  • Pyrimidines
  • Triazoles
  • Voriconazole