Introduction: Spondylodiscitis is an infection of the disc space and surrounding vertebrae. Mycobacterium tuberculosis and bacterial infections are the most prevalent causes, but fungal spondylodiscitis is comparatively uncommon. Mycotic infections are most commonly caused by Candida and Aspergillus species. Aspergillus is a saprophytic fungus that lives mostly in soil and plants. The incidence of Aspergillus affecting the bone among all cases of invasive aspergillosis is estimated to be 3%. They infiltrate the spine in immunocompromised patients, such as those who have had an organ transplant, are on chronic steroid medication, or are undergoing chemotherapy.

Case Report: An adult malewith Type 2 Diabetes Mellitus, Hypertension and alcoholic liver disease was diagnosed with B-Cell Acute Lymphoblastic Leukemia with CALLA positive, FISH Negative. He was started on chemotherapy with G-MALL 07/03 regimen. During BFM 76/79 Re-intensification phase II the patient complained severe lower back pain. A CT guided biopsy from the area previously diagnosed to have Discitis (T4-T5 disc bulge soft tissue) showed negative for malignancy. In view of persistent backache, MRI of whole spine and pelvis was done, which revealed L4-L5 disc inflammation of infectious etiology. Surgery for L4-L5 stabilization and biopsy from the same region analyzed with molecular PCR revealed Aspergillus spp. Patient was initiated on Anti-fungal agents.

Conclusion: Invasive aspergillosis most commonly affects the sinopulmonary tract, with the lung being the most common location of infection, while Aspergillus osteomyelitis is rare. Contiguity, hematogenous spread, and direct implantation are all factors that affect bone tissues. The prevalence of Aspergillus disrupting the bone is believed to be 3% of all cases of invasive aspergillosis, with rates ranging from 1 in 10,000 to 1 in 250,000. Treatment outcomes are greatly influenced by a variety of factors, including neurological illnesses, underlying conditions, and early detection and management.