Metagenomic next-generation sequencing enabled diagnosis of Aspergillus spondylitis in an immunocompetent patient: a case report and literature review

The diagnosis of <i>Aspergillus</i> spondylitis is often delayed or missed. Doctors should consider <i>Aspergillus</i> spondylitis in the differential diagnosis of unexplained low back pain so that appropriate treatment can be administered to prevent spinal cord injury and disability. <i>Aspergillus</i> 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 <i>Aspergillus</i> spondylitis and tuberculous spondylitis. Prompt diagnosis and treatment can improve the patient's prognosis.