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Hematogenous Candida vertebral osteomyelitis treated with ketoconazole.

B A Dijkmans, M I Koolen, R P Mouton

    Infection
    |September 1, 1982
    PubMed
    Summary

    This case study details a patient with systemic lupus erythematosus who developed Candida vertebral osteomyelitis. Successful treatment with ketoconazole led to impressive recovery and no recurrence after 12 months.

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    Area of Science:

    • Mycology
    • Infectious Diseases
    • Rheumatology

    Background:

    • Systemic lupus erythematosus (SLE) patients are immunocompromised, increasing susceptibility to opportunistic infections.
    • Previous use of glucocorticosteroids and parenteral nutrition can be risk factors for invasive fungal infections.
    • Central venous catheterization, used for parenteral nutrition, is a potential source for bloodstream candidiasis.

    Observation:

    • Candida vertebral osteomyelitis was diagnosed in an SLE patient.
    • Evidence included X-ray findings and positive Candida albicans cultures from lumbar vertebral biopsies.
    • A prior episode of candidemia was linked to a removed subclavian catheter.

    Findings:

    • The patient received seven months of ketoconazole treatment for the vertebral osteomyelitis.

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  • Clinical and radiographic assessments indicated an impressive recovery.
  • No signs of recurrence were observed 12 months after discontinuing ketoconazole.

    • Implications:

    • This case highlights the importance of considering invasive fungal infections, such as Candida vertebral osteomyelitis, in immunocompromised patients.
    • Effective antifungal therapy, like ketoconazole, can lead to successful outcomes in complex cases.
    • Long-term monitoring is crucial to ensure sustained recovery and prevent relapse in patients with opportunistic infections.