Candida albicans osteomyelitıs in a diabetic foot ulcer

Yener, Serkan; Topcu, Alpaslan; Manisalı, Metin; Çömlekçi, Abdurrahman; Yeşil, Sena

doi:10.1016/j.jdiacomp.2007.10.005

Cited by 14 publications

(6 citation statements)

References 4 publications

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“…So species identification of Candida was essential for successful management [37]. Moreover, candidal infection in diabetic foot was a rare entity and was previously described in five reports by Heald et al [34]; Missoni et al [36]; Yener et al [38]; Chellan et al [8] and Nithyalakshmi et al [9]. Since, our reports confirmed the prevalence of Candida albicans and non albicans in diabetic foot infections along with antifungal susceptibility pattern.…”

Section: Discussionsupporting

confidence: 80%

Prevalence of yeast in diabetic foot infections

Sugandhi

Prasanth

2016

Int J Diabetes Dev Ctries

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Diabetic foot infections are a serious threat which cause a long term of hospitalization of diabetes patients and lead to amputations. Hence, prompt diagnosis is an important criterion in the treatment of these infections. This study was carried out to determine the prevalence of yeast in diabetic foot infections. The pus samples were collected from patients presenting with diabetic foot ulcer and processed for microbiological investigation. The patients investigated comprised of 82 males and 78 females. Most of the patients were grade I ulcers followed by grade II ulcers. Out of 160 samples, 138 samples were culture positive, in which yeast isolate Candida glabrata was the predominant isolate followed by Candida albicans, Candida dubliniensis, Candida krusei and Candida tropicalis. C. albicans and C. dubliniensis were differentiated by using tobacco agar due to the presence of hyphal fringes. The methylene blue sabouraud dextrose agar and corn meal agar were also used to differentiate C. albicans from non albicans. The antifungal susceptibility pattern showed 29 % of C. albicans was sensitive to Amphotericin B and Clotrimazole, while 75 % of C. glabrata was sensitive to Amphotericin B, Ketoconazole and Itraconazole. C. dublinensis and C. albicans showed the highest percentage of resistant to Ketoconazole, Fluconazole, Nystatin and Itraconazole. Thus, the results indicating that effective alternate drug of choice are required and the proper selection of antifungal agents will play an important role for the treatment of fungal foot infections. This study will also add substantial knowledge of yeast as one of the pathogenic organisms in diabetic foot infections.

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Section: Discussionsupporting

confidence: 80%

Prevalence of yeast in diabetic foot infections

Sugandhi

Prasanth

2016

Int J Diabetes Dev Ctries

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“…8 However, Candida OM of the foot has been described in the literature as well. [7][8][9][10][11][12] Risk factors for Candida OM are numerous and include immunocompromise, prolonged broad-spectrum antibacterial therapy, extended hospital stay, malignancy, and surgical intervention. 7,13 Diabetes is a known immunocompromised condition.…”

Section: Discussionmentioning

confidence: 99%

“…In their 17-patient case series, they describe 1 biopsy-confirmed C albicans OM case in a type 1 diabetic patient. 11 Furthermore, in 2009, Yener et al 12 described a single case of bone biopsy–confirmed C albicans in a man with type 2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

Fungal Osteomyelitis in Diabetic Foot Infections: A Case Series and Comparative Analysis

Torrence

Schmidt

2018

The International Journal of Lower Extremity Wounds

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Fungal osteomyelitis (OM) is relatively rare. There is scarce literature discussing fungal OM in diabetic foot infections (DFIs). This case series explores the clinical characteristics of patients treated at a large tertiary academic center for DFI and found to have a causative agent of fungal origin in their bone on surgical intervention. Between July 2017 and March 2018, a prospective longitudinal analysis was performed of patients with diabetes admitted to our institution who underwent operative management of OM. Demographic, clinical, radiographic, and laboratory data were collected for all patients. Data between bacterial and fungal OM cohorts was analyzed for differences and similarities in patient characteristics and outcomes. All patients were followed 20 weeks postoperatively. Five patients with fungal OM were identified from the 35 cases where OM was confirmed through podiatric surgical intervention. In each fungal case, a Candida species was isolated from operative bone culture which included subspecies Candida albicans, C parapsilosis, and C glabrata. A P value ⩾.05 was found in clinical characteristics between our cohorts. Wound healing was achieved in 40% of patients with fungal OM, and oral fluconazole successfully treated Candida OM in the cases that achieved healing. Diabetes can increase the risk of Candida OM. In DFIs, fungus can impede wound healing if not recognized and treated. Because Candida OM is typically indolent in nature, bone biopsy and mycological culture is recommended for definitive diagnosis and treatment.

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“…Usually, a single bone of a vertebra, a rib, or the sternum is the infectious focus. 5,17,27,42,43 Candida osteomyelitis of the foot is rarely seen, but it is important to remember that it may occur. We identified only six previously described cases in which polymicrobial osteomyelitis was caused by two or more species of Candida.…”

Section: Discussionmentioning

confidence: 99%

Bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei: a case report and an updated literature review

Kaldau

Brorson

Jensen

et al. 2012

International Journal of Infectious Diseases

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Candida osteomyelitis should be considered when a patient presents with risk factors and pain without previous trauma, because Candida, despite being part of the normal flora, is the fourth leading cause of hematogenous nosocomial infections. The recommended treatment is surgery and fluconazole as monotherapy or initially combined with a fungicidal agent, either a different amphotericin B formulation or an echinocandin.

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Candida albicans osteomyelitıs in a diabetic foot ulcer

Cited by 14 publications

References 4 publications

Prevalence of yeast in diabetic foot infections

Prevalence of yeast in diabetic foot infections

Fungal Osteomyelitis in Diabetic Foot Infections: A Case Series and Comparative Analysis

Bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei: a case report and an updated literature review

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