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Sacral colpopexy followed by refractory Candida albicans osteomyelitis and discitis requiring extensive spinal
Cara L Grimes1, Jasmine Tan-Kim, Steven R Garfin
1From the University of California, San Diego, Department of Reproductive Medicine, Division of Female Pelvic Medicine and Reconstructive Surgery, and Department of Orthopedics, La Jolla, and Kaiser Permanente San Diego, Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, San Diego, California.
Background:
Sacral colpopexy is an effective approach to treat vaginal vault prolapse. We report a case of serious Candida albicans infection at the site of sacral mesh attachment.
Case:
A 63-year-old woman developed back pain 4 months after sacral colpopexy. Imaging revealed L5 and S1 osteomyelitis and discitis. This was refractory to medical management and surgical debridement with mesh removal and tissue excision in the surgical plane. Cultures demonstrated C albicans. This ultimately required extensive spinal surgery, including two discectomies, L5 corpectomy, partial corpectomies, canal decompression, strut fusion, and posterior screw and rod stabilization and fusion.
Conclusion:
C albicans lumbosacral osteomyelitis and discitis is a rare but serious complication after sacral colpopexy that can result in significant morbidity.