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Candida albicans osteomyelitis in an infant: a case report and literature review
Nancy Pan1, Ronit Herzog, John S Blanco
1Department of Medicine, Division of Pediatric Rheumatology, Hospital for Special Surgery, New York, NY, USA.
Insights
Candida albicans osteomyelitis is rare in children, typically affecting neonates or immunocompromised individuals. This case highlights an unusual presentation in a healthy toddler, emphasizing the need for broader diagnostic considerations.
Area of Science:
- Mycology
- Pediatric Infectious Diseases
- Skeletal Infections
Background:
- Skeletal infections caused by Candida albicans (C. albicans) are infrequent, predominantly documented in adult populations.
- Pediatric cases of C. albicans osteomyelitis are rare, with most reported instances occurring in neonates with specific risk factors or in severely immunocompromised children.
Observation:
- This report details an atypical case of C. albicans osteomyelitis and arthritis in a 1-year-old boy lacking any immunodeficiency.
- The patient's presentation was characterized by a delayed diagnosis due to an indolent and subacute clinical course, likely originating in the neonatal period.
Findings:
- A comprehensive literature search revealed a lack of recent reviews on C. albicans osteomyelitis specifically in pediatric patients.
- The case study contributes to understanding the spectrum of Candida osteomyelitis in children, particularly in non-immunocompromised individuals.
Implications:
- The findings underscore the importance of considering C. albicans as a potential pathogen in pediatric skeletal infections, even in the absence of typical risk factors.
- This case and literature review inform the diagnostic and management strategies for pediatric patients diagnosed with Candida osteomyelitis.
Abstract:
Skeletal infections secondary to Candida albicans are uncommon and described primarily in adults. Nearly all 22 pediatric cases of C. albicans osteomyelitis described to date have occurred in neonates with specific risk factors or in children with a severe immunodeficiency. We report an unusual presentation of C. albicans osteomyelitis and arthritis in a 1-year-old boy without an immunodeficiency, which led to a delayed diagnosis. He most likely developed C. albicans arthritis and osteomyelitis during the neonatal period with a subsequent indolent and subacute presentation. Our literature search found no prior or recent reviews of C. albicans osteomyelitis in pediatric patients. On the basis of this patient and the case reports previously published, we discuss an approach to the evaluation and management of pediatric patients with Candida osteomyelitis.
