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'Fungal spondylodiscitis in a non-immunocompromised patient'

Vanda Cristina Jorge1, Catarina Cardoso, Carla Noronha

  • 1Department 2, Curry Cabral's Hospital, Lisbon, Portugal. vandacristinajorge@gmail.com

BMJ Case Reports
|May 19, 2012
PubMed

Insights

This case study highlights a rare instance of fungal spondylodiscitis caused by Candida albicans in a 75-year-old male. Despite no initial signs of immunosuppression, the patient experienced severe back pain, leading to a diagnosis and successful treatment.

Area of Science:

  • Infectious Diseases
  • Mycology
  • Spinal Surgery

Background:

  • Spondylodiscitis, an infection of the spine and discs, is typically bacterial.
  • Fungal spondylodiscitis is rare, particularly in non-immunocompromised individuals, often presenting with delayed diagnosis due to subtle symptoms.
  • Spinal infections can lead to significant morbidity and functional impairment if not promptly treated.

Observation:

  • A 75-year-old male presented with constitutional symptoms and severe back pain.
  • The patient had a recent history of complex abdominal surgery, ICU stay, and fungal endophthalmitis.
  • Magnetic resonance imaging (MRI) confirmed spondylodiscitis at the L5/S1 level.

Findings:

  • Surgical debridement revealed Candida albicans as the causative agent.
  • Despite a complex medical history, the patient showed no overt signs of immunosuppression.
  • Treatment included surgical intervention and high-dose liposomal amphotericin B.

Implications:

  • This case underscores the importance of considering fungal pathogens in spondylodiscitis, even without clear immunocompromise.
  • Prompt diagnosis and aggressive treatment, including surgical debridement and antifungal therapy, are crucial for managing fungal spinal infections.
  • Further research may elucidate risk factors and optimal management strategies for non-immunocompromised patients with fungal spondylodiscitis.

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