{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:00:38Z","timestamp":1784761238763,"version":"3.55.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Aspergillus fumigatus<\/jats:italic> spondylitis is a rare fungal spondylitis that often occurs in immunocompromised patients. This article reports a case of <jats:italic>Aspergillus<\/jats:italic> spondylitis with specific image signs, which is rarely reported in an immunocompetent patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>This is a case of L3-4 segmental <jats:italic>Aspergillus<\/jats:italic> spondylitis diagnosed. The diagnosis was confirmed by intraoperative metagenomic next-generation sequencing (mNGS) testing of the diseased tissue. The patient was treated with voriconazole and underwent surgical debridement and internal fixation with pedicle screws.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The diagnosis of <jats:italic>Aspergillus<\/jats:italic> spondylitis is often delayed or missed. Doctors should consider <jats:italic>Aspergillus<\/jats:italic> spondylitis in the differential diagnosis of unexplained low back pain so that appropriate treatment can be administered to prevent spinal cord injury and disability. <jats:italic>Aspergillus<\/jats:italic> spondylitis usually results in endplate inflammatory response line on fluid or enhancement sequences and a diffuse low signal in the diseased vertebral body on T2-weighted imaging (T2WI). It also results in large paraspinal abscesses, which requires further research to better differentiate between <jats:italic>Aspergillus<\/jats:italic> spondylitis and tuberculous spondylitis. Prompt diagnosis and treatment can improve the patient\u2019s prognosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1575363","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T04:11:48Z","timestamp":1745986308000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Metagenomic next-generation sequencing enabled diagnosis of Aspergillus spondylitis in an immunocompetent patient: a case report and literature review"],"prefix":"10.3389","volume":"12","author":[{"given":"Zhou","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirui","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiying","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanming","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weijian","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"4268468","DOI":"10.1155\/2019\/4268468","article-title":"Progressive back pain due to aspergillus nidulans vertebral osteomyelitis in an immunocompetent patient: Surgical and antifungal management.","volume":"2019","author":"Lyons","year":"2019","journal-title":"Case Rep Orthopedics."},{"key":"B2","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1016\/j.jos.2020.09.003","article-title":"Voriconazole-treated aspergillus vertebral osteomyelitis in an immunocompetent patient.","volume":"28","author":"Ayd\u0131n","year":"2023","journal-title":"J. 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