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Aspergillus terreus Spondylodiscitis in an Immunocompromised Child

Sohn, Young Joo, MD*; Yun, Jung Ha, MD*; Yun, Ki Wook, MD*,†; Kang, Hyoung Jin, MD*,†,‡; Choi, Eun Hwa, MD*,†; Shin, Hee Young, MD*,†,‡; Lee, Hoan Jong, MD*,†

The Pediatric Infectious Disease Journal: February 2019 - Volume 38 - Issue 2 - p 161–163
doi: 10.1097/INF.0000000000002125
Immunology Reports

We report the case of a 12-year-old immunocompromised boy with spondylodiscitis of the thoracolumbar spine caused by Aspergillus terreus. Microbiologic diagnosis was confirmed by inoculation of aspiration fluid into blood culture bottles. Because of noncompliance, the patient was treated with extended voriconazole therapy (23 months) with regular serum drug concentration monitoring and intermittent direct observation therapy in an outpatient clinic. The Aspergillus genus contains species that are important causes of morbidity and mortality in immunocompromised hosts. Although the lung is the main target of invasive Aspergillosis, more severe forms such as Aspergillus osteomyelitis can occur.1 A. fumigatus is the most common cause of Aspergillus osteomyelitis, causing 55%–61% of all cases, whereas A. terreus causes 2.3%–2.8% of cases. The vertebral bodies are the most commonly affected sites, occurring in 46%–49% of cases.2 , 3 Here, we report the case of an immunocompromised 12-year-old boy with thoracolumbar spondylodiscitis caused by A. terreus.

From the *Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, Korea

Department of Pediatrics

Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Accepted for publication May 21, 2018.

The authors have no funding or conflicts of interest to disclose.

Address for correspondence: Ki Wook Yun, MD, Department of Pediatrics, Seoul National University Children’s Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea. E-mail: pedwilly@snu.ac.kr.

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