Paracoccidioidomycosis in the spine: case report and review of the literature

• Published in: São Paulo medical journal Vol. 134; no. 3; pp. 263 - 267
• Main Authors: Alvarenga, José Alexandre Lopes da Silva, Martins, Délio Eulálio, Kanas, Michel, Elizeche, Hugo Gustavo Kunzle, Dell'Aquila, Adriana Macêdo, Fernandes, Eloy De Avila, Wajchenberg, Marcelo, Puertas, Eduardo Barros
• Format: Journal Article
• Language: English
• Published: Brazil Associação Paulista de Medicina - APM 01-05-2016; Associação Paulista de Medicina
• Subjects: Aged; Biopsy; Diagnosis, Differential; Discitis; Humans; Low Back Pain - diagnosis; Magnetic Resonance Imaging; Male; MEDICINE, GENERAL & INTERNAL; Osteomyelitis; Paracoccidioides; Paracoccidioides - isolation & purification; Paracoccidioidomycosis; Paracoccidioidomycosis - diagnostic imaging; Paracoccidioidomycosis - microbiology; Paracoccidioidomycosis - pathology; Spinal Cord Diseases - diagnostic imaging; Spinal Cord Diseases - microbiology; Spinal Cord Diseases - pathology; Spine; Osteomyelitis; Osteomielite; Coluna vertebral; Discite; Spine; Paracoccidioides; Paracoccidioidomycosis; Discitis; Paracoccidioidomicose
• ISSN: 1516-3180; 1806-9460; 1806-9460; 1516-3180
• DOI: 10.1590/1516-3180.2015.02691801

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.
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.
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.