Imaging Findings of Fungal Infections of Spine and Spinal Cord

Fungal infections of the spine are rare and most often infect susceptible individuals. Most common infective agents are Candida, Aspergillus, Cryptococcus, Coccidioides and Histoplasma. Infection reaches the spine through haematogenous route and direct spread from an adjacent infected organ or during surgical procedures. It leads to vertebral osteomyelitis, intervertebral disc infection resulting in reduced disc height, endplate erosions and epidural and paravertebral soft tissue masses. Imaging findings are non-specific but useful for discriminating infections from degenerative disease changes and neoplastic conditions. Imaging findings of various common fungal infections affecting the spine are reviewed along with some unusual and rare agents like Scedosporium prolificans. In addition, postoperative fungal infections and infection associated with contaminated prednisolone injection are also briefly reviewed.