Vertebral aspergillosis. A case report and review of the literature.

A case of Aspergillus osteomyelitis of the spine is presented and the world literature is reviewed, for a total of 32 cases. Aspergillus osteomyelitis is rare, but the spine is most frequently affected. It can be induced hematogenously, by contiguity or by direct inoculation. Up to now medical treatment has been based on amphotericin B, but its toxicity is problematic. Itraconazole and fluconazole do not have this shortcoming. Additional surgery has been advocated in the past. In the present series combined medical-surgical treatment (20 cases) led to a higher survival rate (70%) than medical treatment (12 cases: 58%), but neurological recovery was much more frequent in the second group (40% versus 13%).