Blastomycosis of the lumbar spine: Case report and review of the literature, with emphasis on diagnostic laboratory tools and management

A. G. Hadjipavlou, J. T. Mader, H. J.W. Nauta, J. T. Necessary, G. Chaljub, A. Adesokan

    Research output: Contribution to journalArticle

    21 Scopus citations

    Abstract

    We report on me conservative and surgical management of a patient with blastomycosis of the lumbar spine, causing severe and crippling deformity. The diagnosis was made through biopsy. Curative removal, reconstruction and realignment of the spine were achieved. Imaging modalities were highlighted, with a detailed discussion of the histology and conservative and surgical management. We emphasize the importance of early, aggressive treatment of blastomycosis to prevent deformity and disability, and to enable identification of the best management of a destructive lesion with deformity. This case demonstrates that empirical treatment should not be used in cases of unusual sinus and abscess locations. Specific diagnosis and early treatment are indicated to prevent dreadful complications and spinal deformity resulting from blastomycosis. Aggressive antifungal therapy can cure the disease but does not control complications related to deformity. The latter can only be addressed by surgical reconstruction. We review the literature of surgical treatment, focusing on abscess drainage, bone fusion and posterior instrumentation in the absence of addressing the deformity component.

    Original languageEnglish (US)
    Pages (from-to)416-421
    Number of pages6
    JournalEuropean Spine Journal
    Volume7
    Issue number5
    DOIs
    StatePublished - Nov 17 1998

    Keywords

    • Antifungal
    • Blastomycosis
    • Spine
    • Surgery

    ASJC Scopus subject areas

    • Surgery
    • Orthopedics and Sports Medicine

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