Aspergillus Osteomyelitis and Associated Infections

Aspergillus species are ubiquitous moulds capable of causing a spectrum of invasive infections, among which osteomyelitis and spondylodiscitis represent rare but serious entities. Disease may arise via haematogenous dissemination from pulmonary or sinus foci, by direct inoculation during trauma or surgical procedures, or through contiguous spread. Although immunocompromised hosts—including those with haematological malignancies, chronic granulomatous disease or diabetes—bear the highest incidence, cases in apparently immunocompetent individuals have been increasingly recognised. Clinical presentation is often insidious, with back or limb pain, low-grade fever and neurological signs if spinal involvement occurs. Diagnosis relies on imaging modalities such as magnetic resonance imaging and computed tomography, complemented by culture, histopathology and antigen assays. Management necessitates prolonged antifungal therapy—most commonly with triazoles or amphotericin B—tailored by in vitro susceptibility, alongside surgical debridement when indicated to remove necrotic bone and relieve compression. Despite advances, challenges remain in optimising treatment duration, minimizing toxicity and ensuring early detection to reduce morbidity and mortality worldwide.

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Aspergillus Osteomyelitis and Associated Infections publication trend

The graph below shows the total number of articles in aspergillus osteomyelitis and associated infections across all publications each year (not limited to Nature Index journals).

Technical terms

Osteomyelitis: Infection of bone and marrow characterised by inflammation, bone destruction and potential sequestrum formation.

Spondylodiscitis: Infection involving both the intervertebral disc and adjacent vertebral endplates, often resulting in spinal instability and neurological deficit.

Debridement: Surgical removal of necrotic, infected or non-viable tissue to reduce microbial burden and promote healing.

Antifungal therapy: Use of systemic pharmacological agents (e.g., triazoles, amphotericin B formulations) to inhibit or kill fungal pathogens.

Isavuconazole: A broad-spectrum triazole antifungal with favourable pharmacokinetics and potential for effective bone tissue penetration.

References

1. Aspergillus terreus spondylodiscitis following acupuncture and acupotomy in an immunocompetent host: case report and literature review. Frontiers in Cellular and Infection Microbiology (2024).
2. Spinal infection caused by Aspergillus flavus in a diabetic: a case report and literature review. Frontiers in Medicine (2024).
3. Isavuconazole in the Treatment of Aspergillus fumigatus Fracture-Related Infection: Case Report and Literature Review. Antibiotics (2022).
4. Aspergillus spp. osteoarticular infections: an updated systematic review on the diagnosis, treatment and outcomes of 186 confirmed cases. Medical Mycology (2022).