Medicina (Apr 2023)

Cervico-Dorsal Intramedullary Spinal Cord Abscess with <i>Aspergillus fumigates</i> following Pulmonary Infection in an Immunocompetent Patient

  • Vasile Deniss Mereuta,
  • Anca Sava,
  • Cristinel Ionel Stan,
  • Lucian Eva,
  • Gabriela Florenta Dumitrescu,
  • Nicolaie Dobrin,
  • Cornelia Tudorache,
  • Alexandru Chiriac,
  • Irina Ruxandra Strambu,
  • Dragos Andrei Chiran,
  • Ana Maria Dumitrescu

DOI
https://doi.org/10.3390/medicina59040806
Journal volume & issue
Vol. 59, no. 4
p. 806

Abstract

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Invasive forms of aspergillosis of the nervous system are relatively rare and are usually diagnosed in immunocompromised patients. We present the case of a young female patient, treated in the last two months with corticosteroids and antifungal drug for pulmonary aspergillosis, who developed progressive paraparesis. An intramedullary abscess at the C7–D1 level was identified and the lesion was treated with a combination of surgery and antifungal therapy. Histopathologic findings of surgical specimens showed myelomalacia with Aspergillus hyphae and a peripheral rim of neutrophils. We consider that the use of multiple drugs and corticosteroids for our patient’s initial community pneumonia could be the factor that transformed her into a mildly immunocompromised individual and permitted the Aspergillus spp. to disseminate through the blood and into the spinal cord. Moreover, we highlight the fact that more attention should be paid to living and working conditions of the patients, as a simple colonization of the lung with Aspergillus spp. could develop, in a short time, into an invasive disease with a high risk of mortality.

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