Imaging of Fungal Spondylodiscitis

Fungal spondylodiscitis is most commonly encountered in immunocompromised patients. The incidence of fungal infections has increased in the past decade. Candida and Aspergillus are the most common causes of opportunistic fungal infection. The imaging findings are similar to that of pyogenic infection, with T1-hypointense signal at the infected vertebral end plates. However, abnormal T2-weighted signal change is relatively less commonly identified in patients with fungal spondylodiscitis. Even though fungal spondylodiscitis is less common than pyogenic or tuberculous involvement, it is important to consider fungal infection in the differential diagnosis and utilize the clinical history and the patient presentation to enable a more accurate imaging diagnosis.