Paracoccidioidomycosis in the spine

case report and review of the literature

Authors

  • José Alexandre Lopes da Silva Alvarenga Universidade Federal de São Paulo
  • Délio Eulálio Martins Universidade Federal de São Paulo
  • Michel Kanas Universidade Federal de São Paulo
  • Hugo Gustavo Kunzle Elizeche Universidade Federal de São Paulo
  • Adriana Macêdo Dell’Aquila Universidade Federal de São Paulo
  • Eloy De Avila Fernandes Universidade Federal de São Paulo
  • Marcelo Wajchenberg Universidade Federal de São Paulo
  • Eduardo Barros Puertas Universidade Federal de São Paulo

Keywords:

Paracoccidioides, Paracoccidioidomycosis, Spine, Discitis, Osteomyelitis

Abstract

CONTEXT: Paracoccidioidomycosis is a systemic form of mycosis that spreads hematogenously, secondarily to reactivation of lung infection or infection at another site or to new exposure to the causative agent. Few cases of bone involvement have been reported in the literature and involvement of the spine is extremely rare. CASE REPORT: We describe a case of a 68-year-old male patient with spondylodiscitis at the levels L4-L5 caused by presence of the fungus Paracoccidioides brasiliensis, which was diagnosed through percutaneous biopsy. The patient was treated with sulfamethoxazole and trimethoprim for 36 months, with complete resolution of the symptoms. CONCLUSION: Spondylodiscitis caused by the fungus Paracoccidioides brasiliensis is uncommon. However, in patients with chronic low-back pain who live or used to live in endemic regions, this infection should be considered as a possible differential diagnosis.

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Author Biographies

José Alexandre Lopes da Silva Alvarenga, Universidade Federal de São Paulo

MD. Spine Resident, Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.

Délio Eulálio Martins, Universidade Federal de São Paulo

MD, PhD. Attending Physician, Department of Orthopedics and Traumatology, Universidade Federal de Sao Paulo (Unifesp), São Paulo, SP, Brazil.

Michel Kanas, Universidade Federal de São Paulo

MD. Spine Resident, Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.

Hugo Gustavo Kunzle Elizeche, Universidade Federal de São Paulo

MD. Spine Fellow, Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.

Adriana Macêdo Dell’Aquila, Universidade Federal de São Paulo

MD, PhD. Infectious Disease Specialist, Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.

Eloy De Avila Fernandes, Universidade Federal de São Paulo

MD, PhD. Affiliated Professor, Department of Imaging Diagnostics, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.

Marcelo Wajchenberg, Universidade Federal de São Paulo

MD, PhD. Affiliated Professor, Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.

Eduardo Barros Puertas, Universidade Federal de São Paulo

MD, PhD. Full Professor, Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.

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Published

2016-06-02

How to Cite

1.
Alvarenga JAL da S, Martins DE, Kanas M, Elizeche HGK, Dell’Aquila AM, Fernandes EDA, Wajchenberg M, Puertas EB. Paracoccidioidomycosis in the spine: case report and review of the literature. Sao Paulo Med J [Internet]. 2016 Jun. 2 [cited 2025 Mar. 14];134(3):263-7. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/1061

Issue

Vol. 134 No. 3 (2016)

Section

Case Report

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