Spinal aspergillus osteomyelitis

Aspergillus species are uncommon etiologic agents of vertebral osteomyeliti s. We describe two patients with lumbar vertebral aspergillosis precipitate d by the use of corticosteroids and review 39 cases in the literature. The mean age of the population was 40.04 years. There was male predominance (78 % of cases), mainly lumbar involvement (53.7%), and monomicrobial nature of infection; 65.8% of the patients had predisposing factors, while 34.1% had none. Back pain (53.6% of cases) was the predominant symptom, while neurol ogical deficits were present in 29.2% of the patients. White blood cell cou nts were elevated in 12.2% of the patients, and erythrocyte sedimentation r ates were >40 mm/h in 39%. The overall recovery rate was 68.3%, and the mor tality rate was 26.8%. Although aspergillus osteomyelitis is primarily trea ted medically, certain cases may require surgical intervention.