Invasive Pulmonary Aspergillosis in the Epidural Space in a Patient with Acute Myelogenous Leukemia with Myelodysplasia-related Changes: A Case Study and Literature Review of Vertebral Aspergillosis in Japan

• Published in: Internal Medicine Vol. 57; no. 21; pp. 3205 - 3212
• Main Authors: Ono, Ryohei, Sato, Shuku, Okada, Satomi, Kanbe, Emiko, Tanaka, Eri, Tamai, Yotaro
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01-11-2018; Japan Science and Technology Agency
• Subjects: Acute myeloid leukemia; Aged; AML/MRC; Aspergillosis; aspergillus fumigatus; Aspergillus fumigatus - isolation & purification; Bronchiectasis; Case Report; Cough; Cough - etiology; epidural mass; Epidural Space - diagnostic imaging; Epidural Space - microbiology; Female; Fever; Fever - etiology; Humans; Infectious diseases; Internal medicine; Invasive Pulmonary Aspergillosis - complications; Invasiveness; Japan; Laboratory tests; Leukemia; Leukemia, Myeloid, Acute - complications; Leukemia, Myeloid, Acute - microbiology; Literature reviews; Magnetic Resonance Imaging; Mycobacteriosis; Myelodysplastic syndrome; Myelodysplastic Syndromes - complications; Myeloid leukemia; Neutropenia; Pleural effusion; Pneumonia - etiology; review; Spinal Diseases - diagnostic imaging; Spinal Diseases - microbiology; Spine; Vertebrae; vertebral aspergillosis; Japan; AML/MRC; vertebral aspergillosis; aspergillus fumigatus; review; epidural mass
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.1135-18

Vertebral aspergillosis is a rare infectious disease with a high mortality rate. We herein report a 70-year-old woman with acute myelogenous leukemia with myelodysplasia-related changes, nontuberculous mycobacteriosis, and bronchiectasis who presented with a fever and cough. Her clinical symptoms and laboratory test results suggested febrile neutropenia and pneumonia. However, her clinical course was further complicated by lower extremity weakness. Magnetic resonance imaging of the spine showed consolidation contiguously spreading toward the epidural space between the T4 and T5. Cytological testing of the pleural effusion revealed Aspergillus fumigatus. We also review and summarize previously reported cases of vertebral aspergillosis in Japan.