• Junya Shimizu, Mitsunori Yoshimoto, Tsuneo Takebayashi, Kazunori Ida, Katsumasa Tanimoto, and Toshihiko Yamashita.
• From the Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
• Spine. 2014 May 20; 39 (12): E739-42.

Study DesignCase report.ObjectiveWe report a rare case of fungal vertebral osteomyelitis in a tsunami survivor of the Great East Japan Earthquake.Summary Of Background DataFungal vertebral osteomyelitis due to Scedosporium apiospermum (S. apiospermum) is extremely rare. We describe the case of a 45-year-old male who developed vertebral osteomyelitis by S. apiospermum 1 month after near drowning in the huge tsunami after the Great East Japan Earthquake.MethodsThe patient was treated with a combination of percutaneous posterolateral endoscopic debridement and antifungal therapy. The case was evaluated with radiography and computed tomography, and his white blood cell count and C-reactive protein level in serum were measured 20 months after initiation of treatment.ResultsThe patient had no low back pain and both white blood cell count and C-reactive protein had remained normal. Radiographs and computed tomography of lumbar spine demonstrated sclerotic change of endplates and spur formation bridging the L3 and L4 vertebral bodies.ConclusionWe report a rare case of the fungal vertebral osteomyelitis caused by S. apiospermum. If a patient develops severe back pain after a near-drowning episode in dirty water such as a swamp or a river, the clinician should be suspicious of the possibility of fungal spondylitis by S. apiospermum.

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