Case report documents mixed Lactococcus lactis and Aspergillus fumigatus spinal infection in cirrhosis

A 66-year-old woman with hepatitis C-related cirrhosis developed mixed infective spondylitis at L1/2 involving Lactococcus lactis and Aspergillus fumigatus, according to a case report and literature review published in BMC Infectious Diseases. The abstract describes this as the first documented case of spinal infection caused by both organisms in a patient with cirrhosis.

The patient, classified as Child-Pugh class B, was hospitalized with severe hepatitis. During the hospitalization, she developed a catheter-related bloodstream infection and persistent low back pain. Investigators identified the spinal infection through imaging, metagenomic next-generation sequencing and pathological tests. The report states that the diagnostic process was complex, while the literature review found that spinal infections in people with cirrhosis can involve diverse pathogens and that clinical manifestations may be nonspecific, contributing to diagnostic delays.

Management included antibacterial and antifungal treatment, followed by lumbar debridement, bone graft fusion and internal fixation. The patient subsequently showed significant improvement in back pain, normalization of inflammatory markers and overall clinical recovery. These observations describe the course of this individual case; the report does not establish comparative treatment effectiveness or provide evidence from a larger patient series.

The authors characterized the case as clinically rare and diagnostically challenging. In the abstract, they note that the study is a single case report accompanied by a literature review, so its scope is limited to one patient and the findings summarized from the cited literature. They concluded that cirrhosis complicated by mixed bacterial and fungal spinal infection can present with nonspecific symptoms and requires a difficult diagnostic process. The report’s broader clinical advice about considering spinal infection in cirrhotic patients with unexplained back pain, using MRI and etiological testing, and providing individualized antimicrobial treatment and surgery when necessary comes from the authors’ conclusion rather than from comparative clinical outcomes.

Subject of Research: A single-patient case report and literature review of mixed bacterial and fungal spinal infection in a woman with hepatitis C-related cirrhosis.

Article Title: Lactococcus lactis and Aspergillus fumigatus co-infection in cirrhotic patients: a case study and literature review

Article References: Li, Y., Li, S., Hou, Y., & Huang, Q. (2026). Lactococcus lactis and Aspergillus fumigatus co-infection in cirrhotic patients: a case study and literature review. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14461-6

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14461-6

Keywords: case report, liver cirrhosis, spinal infection, spondylitis, Lactococcus lactis, Aspergillus fumigatus, mNGS, lumbar surgery, Lactococcus, lactis, Aspergillus, fumigatus