• Nangorgo J Coulibaly, Grace R Fassina, Emmanuel O Donkor, and Caple A Spence.
• Department of Neurosurgery, University of Oklahoma College of Medicine, Oklahoma City, OK, 73104, USA.
• World Neurosurg. 2024 Sep 4.

BackgroundIntradural spinal fungal infection is a rare phenomenon that can carry a significant increase in morbidity and mortality. In this systematic review and case report presentation of a 75-year-old male with an intradural cervical mass that was diagnosed as a fungal infection intraoperatively. The objective of this paper is to analyze and report on intradural spinal fungal infections in immunocompetent patients.MethodWe performed a systematic literature review following the PRISMA protocol for studies of intradural fungal infections published in the past 25 years. Original articles with a description of treatment outcomes of such patients were included.Results8 studies were included in this review with the addition of the present case. There were 5 males and 4 females with the average age of patients was 45.6-year-old (range 24-75). Aspergillus and Candida species being the most isolated fungal organism. The origin of the lesions was identified and iatrogenic in four cases. Most patients underwent decompressive laminectomy with biopsy, abscess drainage, or resection of the identified lesion. There were two instances of cervical lesions, but most of the lesions were in the thoracic and lumbar spine. Half of the cases reported symptoms improvement, but two patients died from the infection or complications from the infections.ConclusionIntradural fungal infections are rare with only ten total cases reported in the past 25 years. Nonetheless, they can be associated with significant mortality and morbidity. Thus, the timeline from presentation to intervention should be evaluated and determined carefully.Copyright © 2024. Published by Elsevier Inc.

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