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[Vertebral osteomyelitis due to Candida spp].
Dolores Rodríguez1, Carlos Pigrau, Benito Almirante
1Servicio de Enfermedades Infecciosas. Hospital Universitari Vall d'Hebron. Universidad Autónoma de Barcelona. España.
Enfermedades Infecciosas Y Microbiologia Clinica
|December 4, 2003
Summary
Candidal vertebral osteomyelitis is rare but should be suspected in patients with risk factors for candidemia. Early diagnosis and treatment are crucial for managing this uncommon fungal infection.
Area of Science:
- Infectious Diseases
- Mycology
- Spinal Surgery
Background:
- Vertebral osteomyelitis is infrequently caused by Candida species.
- A high index of suspicion is necessary for diagnosing candidal vertebral osteomyelitis.
Observation:
- Three cases of vertebral osteomyelitis due to Candida species were identified over 17 years.
- All patients presented with risk factors for Candida infection, including diabetes mellitus, immunosuppression, central venous catheters, antibiotic use, and parenteral nutrition.
Findings:
- Diagnosis was confirmed via radiographic studies and vertebral specimen cultures in two patients.
- Blood cultures were positive in one patient with concurrent aortic infectious endocarditis.
- Two patients achieved clinical cure with medical management; one relapsed after six months of fluconazole therapy.
Implications:
- Candidal vertebral osteomyelitis is an uncommon but significant clinical entity.
- Suspecting this infection in patients with risk factors for candidemia is essential for timely diagnosis and treatment.
- Effective management strategies are critical to prevent relapse and ensure patient recovery.