Isolated Cryptococcosis of A lumbar Vertebra in an Immunocompetent Patient: A case Report and Literature Review

Overview

Journal Front Surg

Specialty General Surgery

Date 2023 Jan 23

PMID 36684372

Authors

Zhongxiong Jia

Min Tang

Xiaojun Zhang

Xiaojuan Xin

Wei Jiang

Jie Hao

Affiliations

Soon will be listed here.

Abstract

Background: , a kind of fungus, can be found in soil, decayed wood, and avian excreta. Immunocompromised patients are prone to infection caused by , and the lungs and central nervous system are the main target organs. Cryptococcosis rarely occurs in the lumbar vertebra or in immunocompetent patients.

Case Presentation: A 40-year-old adult male with isolated lumbar vertebra cryptococcosis at the L4 vertebra underwent successful lesion removal surgery performed the posterior approach and postoperative administration of an antifungal agent. At the 12-month follow-up, the patient's pain was relieved, and his motor function had improved. Isolated vertebrae infection is a rare infectious disease.

Conclusions: A needle biopsy can confirm the diagnosis of infection. When patients present with unbearable symptoms of nerve compression, posterior depuration combined with postoperative antifungal agents is a good option.

References

Zhou H, Ning G, Feng S, Jia H, Liu Y, Feng H . Cryptococcosis of lumbar vertebra in a patient with rheumatoid arthritis and scleroderma: case report and literature review. BMC Infect Dis. 2013; 13:128. PMC: 3602200. DOI: 10.1186/1471-2334-13-128. View

Gupta S, Chhabra R, Sharma B, Das A, Khosla V . Vertebral cryptococcosis simulating tuberculosis. Br J Neurosurg. 2004; 17(6):556-9. DOI: 10.1080/02688690310001626868. View

Singh R, Xess I . Multiple osseous involvements in a case of disseminated cryptococcosis. Indian J Orthop. 2010; 44(3):336-8. PMC: 2911937. DOI: 10.4103/0019-5413.65158. View

Li Z, Liang J, Shen J, Qiu G, Weng X . Thoracolumbar Scoliosis Due to Cryptococcal Osteomyelitis: A Case Report and Review of the Literature. Medicine (Baltimore). 2016; 95(5):e2613. PMC: 4748889. DOI: 10.1097/MD.0000000000002613. View

Kiertiburanakul S, Wirojtananugoon S, Pracharktam R, Sungkanuparph S . Cryptococcosis in human immunodeficiency virus-negative patients. Int J Infect Dis. 2005; 10(1):72-8. DOI: 10.1016/j.ijid.2004.12.004. View

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. DOI: 10.1016/j.ijid.2014.07.013. View

Govender S, Charles R . Cryptococcal infection of the spine. A case report. S Afr Med J. 1987; 71(12):782-3. View

Legarth R, Christensen M, Calum H, Katzenstein T, Helweg-Larsen J . Cryptococcal rib osteomyelitis as primary and only symptom of idiopathic CD4 penia. Med Mycol Case Rep. 2014; 4:16-8. PMC: 3950534. DOI: 10.1016/j.mmcr.2014.02.002. View

Gurevitz O, Block C, Kopolovic J, Farfel Z, Hassin D . Cryptococcus neoformans vertebral osteomyelitis. J Med Vet Mycol. 1994; 32(4):315-8. View

10.

Chleboun J, Nade S . Skeletal cryptococcosis. J Bone Joint Surg Am. 1977; 59(4):509-14. View

11.

Jain M, Sharma S, Jain T . Cryptococcosis of thoracic vertebra simulating tuberculosis: diagnosis by fine-needle aspiration biopsy cytology--a case report. Diagn Cytopathol. 1999; 20(6):385-6. DOI: 10.1002/(sici)1097-0339(199906)20:6<385::aid-dc12>3.0.co;2-9. View

12.

Lury K, Smith J, Castillo M . Imaging of spinal infections. Semin Roentgenol. 2006; 41(4):363-79. DOI: 10.1053/j.ro.2006.07.008. View

13.

Benesova P, Buchta V, Cerman J, Zak P . Cryptococcosis--a review of 13 autopsy cases from a 54-year period in a large hospital. APMIS. 2007; 115(3):177-83. DOI: 10.1111/j.1600-0463.2007.apm_513.x. View

14.

Minta D, Traore A, Coulibaly I, Diallo K, Soukho-Kaya A, Dolo A . [Non-neuromeningeal cryptococcosis in patients with AIDS in Bamako, Mali: 2 case reports]. J Mycol Med. 2014; 24(2):e65-71. DOI: 10.1016/j.mycmed.2013.11.003. View

15.

Lui G, Lee N, Ip M, Choi K, Tso Y, Lam E . Cryptococcosis in apparently immunocompetent patients. QJM. 2006; 99(3):143-51. DOI: 10.1093/qjmed/hcl014. View

16.

Nadrous H, Antonios V, Terrell C, Ryu J . Pulmonary cryptococcosis in nonimmunocompromised patients. Chest. 2003; 124(6):2143-7. DOI: 10.1016/s0012-3692(15)31671-8. View

17.

Al-Tawfiq J, Ghandour J . Cryptococcus neoformans abscess and osteomyelitis in an immunocompetent patient with tuberculous lymphadenitis. Infection. 2007; 35(5):377-82. DOI: 10.1007/s15010-007-6109-9. View

18.

Li S, Mody C . Cryptococcus. Proc Am Thorac Soc. 2010; 7(3):186-96. DOI: 10.1513/pats.200907-063AL. View

19.

Adsul N, Kalra K, Jain N, Haritwal M, Chahal R, Acharya S . Thoracic cryptococcal osteomyelitis mimicking tuberculosis: A case report. Surg Neurol Int. 2019; 10:81. PMC: 6744792. DOI: 10.25259/SNI-49-2019. View

20.

BEHRMAN R, Masci J, Nicholas P . Cryptococcal skeletal infections: case report and review. Rev Infect Dis. 1990; 12(2):181-90. DOI: 10.1093/clinids/12.2.181. View