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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.
BMC Infectious Diseases
|October 9, 2020
Summary
Invasive Candida krusei infections are rare, and spondylitis is an uncommon complication. This case highlights that antifungal therapy alone may be insufficient for treating Candida krusei spondylitis, often requiring surgical intervention.
Area of Science:
- Infectious Diseases
- Mycology
- Surgical Oncology
Background:
- Invasive Candida krusei infections are infrequent and rarely present with spondylitis.
- Previous cases of Candida krusei spondylitis were treated solely with antifungal medications, contrary to treatment guidelines.
Observation:
- A patient with acute myeloid leukemia undergoing chemotherapy developed Candida krusei candidemia.
- Following antifungal treatment, the patient presented with severe lumbar pain and was diagnosed with spondylitis of the L4 and L5 vertebrae.
- Despite a combination of antifungal agents and conservative management, the patient's symptoms progressed.
Findings:
- Antifungal treatment alone was insufficient for managing Candida krusei spondylitis in this patient.
- Surgical intervention became necessary due to the progressive nature of the infection.
Implications:
- This case suggests that current treatment guidelines for invasive fungal infections may need to be re-evaluated for Candida krusei spondylitis.
- Combined antifungal and surgical approaches may be crucial for successful outcomes in complex cases.
