Abstract
We report on the conservative and surgical management of a patient with blastomycosis of the lumbar spine, causing severe and crippling deformity. The diagnosis was made through biopsy. Curative removal, reconstruction and realignment of the spine were achieved. Imaging modalities were highlighted, with a detailed discussion of the histology and conservative and surgical management. We emphasize the importance of early, aggressive treatment of blastomycosis to prevent deformity and disability, and to enable identification of the best management of a destructive lesion with deformity. This case demonstrates that empirical treatment should not be used in cases of unusual sinus and abscess locations. Specific diagnosis and early treatment are indicated to prevent dreadful complications and spinal deformity resulting from blastomycosis. Aggressive antifungal therapy can cure the disease but does not control complications related to deformity. The latter can only be addressed by surgical reconstruction. We review the literature of surgical treatment, focusing on abscess drainage, bone fusion and posterior instrumentation in the absence of addressing the deformity component.
Similar content being viewed by others
Author information
Authors and Affiliations
Additional information
Received: 19 November 1997 Revised: 6 February 1998 Accepted: 16 April 1998
Rights and permissions
About this article
Cite this article
Hadjipavlou, A., Mader, J., Nauta, H. et al. Blastomycosis of the lumbar spine: case report and review of the literature, with emphasis on diagnostic laboratory tools and management. E Spine J 7, 416–421 (1998). https://doi.org/10.1007/s005860050100
Issue Date:
DOI: https://doi.org/10.1007/s005860050100