Osteoarticular infection by Candida albicans in an infant with cystic fibrosis

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Kerstin Radike1, Steffen Kunzmann1, Marianne Abele-Horn2

  • 1Children's Hospital University of Würzburg, Würzburg, Germany.

Journal of Medical Microbiology
|May 21, 2011
PubMed

Insights

Invasive candidiasis, a rare fungal infection in children, can affect those with cystic fibrosis (CF). This case highlights the need for vigilant monitoring and potentially combination antifungal therapy for CF patients with invasive Candida infections.

Area of Science:

  • Pediatric Infectious Diseases
  • Mycology
  • Cystic Fibrosis Research

Background:

  • Invasive candidiasis is uncommon in pediatric patients post-neonatal period.
  • Risk factors include immunodeficiency, compromised barriers (gastrointestinal, skin), and antibiotic use.
  • Cystic Fibrosis (CF) patients may be susceptible due to underlying health issues.

Observation:

  • A 10-month-old female with cystic fibrosis presented with failure to thrive and pulmonary symptoms.
  • Blood cultures revealed Candida albicans, treated with liposomal amphotericin B.
  • A subsequent osteoarticular infection (left knee) caused by C. albicans occurred.

Findings:

  • Initial liposomal amphotericin B therapy showed insufficient response for the osteoarticular infection.
  • Combined therapy with fluconazole and flucytosine led to patient recovery.
  • No long-term sequelae were observed after a 4-year follow-up.

Implications:

  • Invasive Candida infections are a potential complication in pediatric cystic fibrosis patients.
  • Preventive strategies may be beneficial for at-risk CF individuals.
  • Prolonged combination antifungal treatment might be necessary for invasive infections in this population.

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