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Multifocal osteomyelitis caused by Candida dubliniensis.

Nele Wellinghausen¹, Angelika Moericke¹, Silke Bundschuh²

¹Institute of Medical Microbiology and Hygiene, University Hospital of Ulm, Ulm, Germany.

Journal of Medical Microbiology

|February 12, 2009

Summary

Candida dubliniensis can cause serious infections in immunocompromised patients. This study details the first reported case of multifocal osteomyelitis after stem cell transplantation, highlighting the need for long-term antifungal treatment.

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Area of Science:

Medical Mycology
Infectious Diseases
Hematology

Background:

Candida dubliniensis is an emerging fungal pathogen.
Immunocompromised individuals, particularly those undergoing hematopoietic stem cell transplantation (HSCT), are at increased risk for invasive fungal infections.
Disseminated candidiasis can lead to severe complications in susceptible hosts.

Observation:

A case of multifocal osteomyelitis is reported in a patient post-hematopoietic stem cell transplantation.
The infection was caused by Candida dubliniensis, a yeast species.
This represents the first documented instance of osteomyelitis following disseminated C. dubliniensis infection in an HSCT recipient.

Findings:

Pulsed-field gel electrophoresis (PFGE) was utilized for the molecular typing of the Candida dubliniensis isolates.
The study confirms the potential for C. dubliniensis to cause invasive, multifocal disease in a high-risk patient population.
Long-term antifungal therapy was deemed necessary for managing the disseminated infection and its skeletal complications.

Implications:

This case underscores the importance of recognizing Candida dubliniensis as a significant pathogen in HSCT recipients.
Early diagnosis and appropriate, prolonged antifungal treatment are crucial for improving outcomes in disseminated candidiasis.
The development of PFGE typing aids in understanding the epidemiology and transmission dynamics of C. dubliniensis infections.