Skip to main content
SpringerLink
Log in

Fungal Infections of the Spine Mimicking Tuberculosis

  • Chapter
  • First Online:
Fungal Infections of the Central Nervous System

  • 829 Accesses

Abstract

Both fungal and tubercular infections involving the spine are worldwide problem, owing to considerable rise in the number of immunosuppressed patients in recent years. Unfortunately, clinical picture of fungal infections involving the spine closely mimics tubercular spinal infections; therefore, early recognition and timely intervention of both tuberculous and fungal spine infections is very important. Furthermore, a high index of suspicion is of utmost importance for differential diagnosis of fungal and tuberculous etiologies of spine infections and appropriate medical therapy, antifungal or antitubercular therapy, to reduce the mortality and morbidity in these patients. In this chapter, fungal infections of the spine mimicking tuberculosis are reviewed in terms of epidemiology, clinical and imaging findings, differential diagnosis, treatment, and prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AIDS:

Acquired immunodeficiency syndrome

ATT:

Antitubercular therapy

CSF:

Cerebrospinal fluid

CT:

Computerized tomography

FNAB:

Fine-needle aspiration biopsy

HIV:

Human immunodeficiency virus

IVD:

Intervertebral disc

MRI:

Magnetic resonance imaging

References

  • Aagaard T, Roed C, Dragsted C, Skinhøj P. Microbiological and therapeutic challenges in infectious spondylodiscitis: a cohort study of 100cases, 2006-2011. Scand J Infect Dis. 2013;45:417–24.

    Article  Google Scholar 

  • Acharya J, Gibbs WN. Imaging spinal infection. Radiol Infect Dis. 2016;3:84–91.

    Article  Google Scholar 

  • Broner FA, Garland DE, Zigler JE. Spinal infections in the immunocompromised host. Orthop Clin North Am. 1996;2:37–46.

    Google Scholar 

  • Caldera G, Cahueque M, Cobar A, Gómez G, Rodríguez O. Fungal spondylodiscitis: review. J Spine. 2016;5:2–6.

    Article  Google Scholar 

  • Chemm RK, Wang S, Jaovisidha S, Schmit P, Frieedman L, Bureau NJ, Cardinal E. Imaging of fungal, viral, and parasitic musculoskeletal and spinal diseases. Radiol Clin N Am. 2001;39:357–78.

    Article  Google Scholar 

  • Chen CH, Chen WL, Yen HC. Candida albicans lumbar spondylodiscitis in an intravenous drug user: a case report. BMC Res Notes. 2013;6:529.

    Article  Google Scholar 

  • Clamp JA, Grevitt MP. Spinal infections. Surgery. 2009;27:306–10.

    Google Scholar 

  • Duarte RM, Vaccaro AR. Spinal infection: state of the art and management algorithm. Eur Spine J. 2013;22:2787–99.

    Article  Google Scholar 

  • Frazier DD, Campbell DR, Garvey TA, Wiesel S, Bohlman HH, Eismont FJ. Fungal infections of the spine. Report of eleven patients with long-term follow-up. J Bone Joint Surg Am. 2001;83:560–5.

    Article  CAS  Google Scholar 

  • Gouliouris T, Aliyu SH, Brown NM. Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother. 2010;65(suppl 3):11–24.

    Google Scholar 

  • Gupta SK, Chhabra R, Sharma BS, Das A, Khosla VK. Vertebral cryptococcosis simulating tuberculosis. Br J Neurosurg. 2003;17:556–9.

    Article  CAS  Google Scholar 

  • Gupta R, Kushwaha S, Behera S, Jaiswal A, Thakur R. Vertebro-cerebral cryptococcosis mimicking tuberculosis: a diagnostic dilemma in countries with high burden of tuberculosis. Indian J Med Microbiol. 2012;30:245–8.

    Article  CAS  Google Scholar 

  • Hadjipavlou AG, Mader JT, Nauta HJ, Necessary JT, Chaljub G, Adesokan A. Blastomycosis of the lumbar spine: case report and review of the literature, with emphasis on diagnostic laboratory tools and management. Eur Spine J. 1998;7:416–21.

    Article  CAS  Google Scholar 

  • Hali T. Spinal infections. Eur J Radiol. 2004;50:120–33.

    Article  Google Scholar 

  • Hannallah D, Altman D, Kang J. Infections in the spine. Oper Tech Orthop. 2002;12:310–4.

    Article  Google Scholar 

  • Houda B, Wafa A, Zoubida TM, Mohamed A, Mohamed A, Hicham H. Vertebral cryptococcosis in an immunocompetent patient—a case report. Pan Afr Med J. 2011;8:42.

    Article  Google Scholar 

  • Jain M, Sharma S, Jain TS. Cryptococcosis of thoracic vertebra simulating tuberculosis: diagnosis by fine-needle aspiration biopsy cytology-a case report. Diagn Cytopathol. 1999;20:385–6.

    Article  CAS  Google Scholar 

  • James SL, Davies AM. Imaging of infectious spinal disorders in children and adults. Eur J Radiol. 2006;58:27–40.

    Article  CAS  Google Scholar 

  • Kathuria MK, Gupta RK. Fungal infections. In: Gupta RK, Lufkin RB, editors. MR imaging and spectroscopy of central nervous system infections. New York: Kluwer Press; 2001. p. 177–203.

    Chapter  Google Scholar 

  • Kim CW, Perry A, Currier B, Yaszemski M, Garfin SR. Fungal infections of the spine. Clin Orthop Relat Res. 2006;444:92–9.

    Article  Google Scholar 

  • Kulcheski ÁL, Graells XS, Benato ML, Santoro PG, Sebben AL. Fungal spondylodiscitis due to Candida albicans: an atypical case and review of the literature. Rev Bras Ortop. 2015;50:739–42.

    Article  Google Scholar 

  • Lai Q, Liu Y, Yu X, Lv X, Wang Q, Zhou Y, Guo R, Zhang B. Diagnosis and treatment of nonadjacent cryptococcal infections at the L1 and S1 vertebrae. Orthopade. 2017;46:85–9.

    Article  Google Scholar 

  • Lindner A, Becker G, Warmuth-Metz M, Schalke BC, Bogdahn U, Toyka KV. MRI findings of spinal intra-medullary abscess caused by Candida albicans: a case report. Neurosurgery. 1995;36:411–3.

    Article  CAS  Google Scholar 

  • Martinez-Del-Campo E, Kalb S, Rangel-Castilla L, Moon K, Moran A, Gonzalez O, Soriano-Baron H, Theodore N. Spinal coccidioidomycosis: a current review of diagnosis and management. World Neurosurg. 2017;108:69–75.

    Article  Google Scholar 

  • Moorthy S, Prabhu NK. Spectrum of MR imaging findings in spinal tuberculosis. AJR Am J Roentgenol. 2002;179:979–83.

    Article  Google Scholar 

  • Oksi J, Finnilä T, Hohenthal U, Rantakokko-Jalava K. Candida dubliniensis spondylodiscitis in an immunocompetent patient. Case report and review of the literature. Med Mycol Case Rep. 2013;3:4–7.

    Article  Google Scholar 

  • Pahlavan S, Bhatia NN. Fungal spine. Semin Spine Surg. 2016;28:163–72.

    Article  Google Scholar 

  • Prapruttam D, Hedgire SS, Mani SE, Chandramohan A, Shyamkumar NK, Harisinghani M. Tuberculosis-the great mimicker. Semin Ultrasound CT MR. 2014;35:195–214.

    Article  Google Scholar 

  • Rankine JJ. MRI of spinal infection. Curr Orthop. 2004;18:426–33.

    Article  Google Scholar 

  • Schmiedel Y, Zimmerli S. Common invasive fungal diseases: an overview of invasive candidiasis, aspergillosis, cryptococcosis, and pneumocystis pneumonia. Swiss Med Wkly. 2016;146:w14281.

    PubMed  Google Scholar 

  • Sharma R. Fungal infections of the nervous system: current perspective and controversies in management. Int J Surg. 2010;8:591–601.

    Article  Google Scholar 

  • Sugrue PA, Koski TR. Fungal and tubercular infections of the spine. In: Winn RH, editor. Youmans neurological surgery. 6th ed. Philadelphia, PA: Saunders; 2011. p. 2848–58.

    Chapter  Google Scholar 

  • Sundaram VK, Doshi A. Infections of the spine: a review of clinical and imaging findings. Appl Radiol. 2016;45:10–20.

    Google Scholar 

  • Wang C, Jia N, Zhang L, Liu K, Liu H, Yu H. Imaging findings of cryptococcal infection of the thoracic spine. Int J Infect Dis. 2014;29:162–5.

    Article  CAS  Google Scholar 

  • Weinberg J, Silber JS. Infections of the spine: what the orthopedist needs to know. Am J Orthop. 2004;33:13–7.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Kütahya Health Sciences University School of Medicine, Kütahya, Turkey

    Turan C. Dülgeroğlu

  2. Department of Neurosurgery, Aydın Adnan Menderes University School of Medicine, Aydın, Turkey

    Mehmet Turgut

Authors
  1. Turan C. Dülgeroğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mehmet Turgut
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Aydın Adnan Menderes University, School of Medicine, Aydın, Turkey

    Mehmet Turgut

  2. Department of Pathology, Basavatarakam Indo-American Hospital & Research Institute, Hyderabad, Telangana, India

    Sundaram Challa

  3. Department of Neurosurgery, Avicenne Military Hospital, Mohammed V University in Rabat, Marrakech, Morocco

    Ali Akhaddar

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Dülgeroğlu, T.C., Turgut, M. (2019). Fungal Infections of the Spine Mimicking Tuberculosis. In: Turgut, M., Challa, S., Akhaddar, A. (eds) Fungal Infections of the Central Nervous System. Springer, Cham. https://doi.org/10.1007/978-3-030-06088-6_34

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-06088-6_34

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-06087-9

  • Online ISBN: 978-3-030-06088-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation