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Case report: Candida krusei spondylitis in an immunocompromised patient
Audrey J C Overgaauw1, David C de Leeuw2, Susanne P Stoof3
1Department of Internal Medicine, Amsterdam University Medical Center, location VUmc, Amsterdam, The Netherlands. a.j.c.overgaauw@icloud.com.
Background:
Invasive infections with Candida krusei are uncommon and rarely complicated by spondylitis. Previous described cases were solely treated with antimycotic therapy, despite guidelines recommending surgical interventions.
Case Presentation:
We describe a case of C. krusei spondylitis in a patient treated with chemotherapy for acute myeloid leukemia. After induction chemotherapy, the patient developed a candidemia, which was treated with micafungin. One month after the candidemia, the patient was admitted with severe lumbar pain. Spondylitis of the L4 and L5 vertebra was diagnosed on MR-imaging, with signs suggesting an atypical infection. The patient was treated with anidulafungin combined with voriconazole. Despite maximal conservative management symptoms gradually worsened eventually requiring surgical intervention.
Conclusions:
In contrast to previous case reports, antimycotic treatment alone could be insufficient in treating C. krusei spondylitis.
