Table 1.

Summary of case reports with vertebral osteomyelitis and/or epidural abscess spinal epidural abscess due to L. prolificans infection.

Case,	Age (yrs.)/sex	Predisposing conditions	Presenting symptoms	Infectious foci	Radiographic findings	Pathological findings	Antifungal	Treatments	Outcomes
country (Year)							MICs (μg/mL)
1,	53/F	MM, autologous HSCT, previous	LBP and weakness of right leg	L, S	L2, L3, L5 and S1 vertebral osteomyelitis with intervertebral discitis	Acute inflammatory	ABD 8	- Oral VORI, TBF	Partial recoverya
Australia							ITRA > 16
(2003)5		L. prolificans rhinosinusitis				reaction	VORI 2	- Laminectomy
2,	62/F	Previous spine surgery 5 months	Fever and LBP	L, S	L5 and S1 vertebral osteomyelitis with intervertebral discitis	n/a	ABD 16	- Oral VORI	Complete recovery
Spain							ITRA 8	- Debridement and
(2009)4			1 month				VORI 8	arthrodesis
3,	35/M	Previous spinal epidural anesthesia 15 yrs	Progressive weakness of lower limbs 6 yrs	T	Spinal epidural abscess	Chronic inflammation and fungal hyphae	n/a	- IV and oral VORI	Relapseb
Brazil					at T9 and T10 levels			- Laminectomy and
(2009)6								drainage
The present	57/F	–	Mid thoracic back pain 3 months	T	T8-T9 vertebral osteomyelitis and spinal epidural abscess	Granulomatous inflammation, Splendore-Hoeppli reaction, and fungal hyphae	ABD 8	- Oral VORI, TBF	Ongoing treatment
case,							ITRA > 16	- Laminectomy and
Thailand							VORI 4	removal of
(2017)							POSA > 8	abscess

Abbreviations: ABD, amphotericin B deoxycholate; F, female; HSCT, haematopoetic stem cell transplantation; ITRA, itraconazole; IV, intravenous; L, lumbar, LBP, low back pain; MICs, minimal inhibitory concentrations; MM, multiple myeloma; n/a, not available; POSA, posaconazole; S, sacrum; T, thoracic; TBF, terbinafine; VORI, voriconazole; yrs, years.

^aRecovery of neurological deficits, but LBP and radiographic findings has been unchanged.

^bRelapse following discontinuation of antifungal therapy for 3 months.