Vertebral osteomyelitis due to Candida species

McLeod, Nathan; Fisher, Melanie; LaSala, P. Rocco

doi:10.1007/s15010-019-01294-6

Cited by 12 publications

(7 citation statements)

References 10 publications

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“…Despite innovative treatment protocols developed during the last decades, posttraumatic fracture-related infection (FRI) is still associated with tremendous patient-related and socioeconomic issues in the clinical setting [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Treatment of fracture-related infection of the lower extremity with antibiotic-eluting ceramic bone substitutes: case series of 35 patients and literature review

et al. 2020

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Introduction The current treatment concepts of fracture-related infection (FRI) [Consensus Conference (Anti-Infection Task Force (AITF)) on the definition of acute or chronic osteomyelitis (cOM)] are associated with unsolved challenges and problems, underlining the need for ongoing medical research. Method Literature review of treatments for FRI and description of own cases. Results We could include eight papers with 394 patients reporting treatments and outcome in FRI. The infection was resolved in 92.9% (mean) of all treatments. The mean follow-up was 25 months with a persistent non-union in 7% of the patients. We diagnosed 35 (19f/16m; 56.4 ± 18.6 years) patients with bone infections anatomically allocated to the proximal and distal femur (12×), the pelvis (2×), distal tibia (3×), tibial diaphysis (11×), the ankle joint (4×) and calcaneus (3×). These 35 patients were treated (1) with surgical debridement; (2) with antibiotic-eluting ceramic bone substitutes; (3) bone stabilization (including nail fixation, arthrodesis nails, plates, or external ring fixation), (4) optionally negative pressure wound therapy (NPWT) and (5) optionally soft tissue closure with local or free flaps. The mean follow-up time was 14.9 ± 10.6 months (min/max: 2/40 month). The overall recurrence rate is low (8.5%, 3/35). Prolonged wound secretion was observed in six cases (17.1%, 6/35). The overall number of surgeries was a median of 2.5. Conclusion The results in the literature and in our case series are explicitly promising regarding the treatment of posttraumatic fracture-related infection.

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Section: Introductionmentioning

confidence: 99%

Treatment of fracture-related infection of the lower extremity with antibiotic-eluting ceramic bone substitutes: case series of 35 patients and literature review

et al. 2020

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“…The rarity of the disease often leads to its misdiagnosis as a bacterial or tubercular infection. 4,5 Appropriate treatment is often delayed, which can lead to poor outcomes. The outcomes of medical and surgical treatments are not always predictable.…”

Section: Discussionmentioning

confidence: 99%

Atypical fungal thoracic vertebral osteomylitis resembling metastatic tumor and literature review of fungal vertebral osteomylitis

Sun

et al. 2020

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Case DescriptionFungal vertebral osteomylitis is a rare disease that difficult to diagnosis and cure. Because the early specific clinical manifestations of this disease are few and atypical, it is often missed or misdiagnosed, resulting in treatment delay and aggravation of the disease.ObjectiveTo report a rare case of cryptococcal osteomyelitis that resembles metastatic tumor happened in an immunecompromised patient with a history of mantle cell lymphoma and to review cases reported in literature.Study DesignBased on imaging studies, metastatic tumor was highly suspected. For a further examination and therapy, the patient was referred to our spine clinic. After admission to our clinical, chest and abdominal CT were checked to evaluate the disease status.TreatmentsAfter general anesthesia, posterior thoracic pedicle screw fixation (T2.3.5.6) were performed, followed by posterior laminectomy and decompression of T4 vertebral body. The right facet joint of T3/4, costal transverse joint, right pedicle and transverse process of T4 vertebra were fully removed and curetted. After careful hemostasis, posterolateral bone grafting was performed. The nail-rod connection is fixed.OutcomesThe postoperative intercostal neuralgia and chest pain were significantly relieved, without complications. The postoperative pathological results were suppurative inflammation with focal granuloma formation, dead bone formation and fungal (cryptococcal) infection. ConclusionsWhen complicated with vertebral fungal spondylitis, no obvious abnormality and fever can be found. When pain or nerve dysfunction caused by spinal cord compression or nerve root compression occurs, surgical treatment can effectively relieve clinical symptoms.

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“…Osteomyelitis -including spondylitis -due to Candida species is rare. A recent retrospective study in a tertiary hospital in the United States counted only 15 cases of Candida vertebral osteomyelitis in 12 years [1]. Risk factors are a previous candidemia, prior use of antibiotics, previous (enteric) surgery, central venous catheters and diabetes mellitus [3,5,7].…”

Section: Discussionmentioning

confidence: 99%

“…Candida spondylitis is an uncommon condition and in most cases due to an infection with Candida albicans [1,2]. Candida krusei as a causative agent is rare and only two cases have been reported so far, exclusively in immunocompromised patients [3,4].…”

Section: Introductionmentioning

confidence: 99%

Case report: Candida krusei spondylitis in an immunocompromised patient

et al. 2020

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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.

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Vertebral osteomyelitis due to Candida species

Cited by 12 publications

References 10 publications

Treatment of fracture-related infection of the lower extremity with antibiotic-eluting ceramic bone substitutes: case series of 35 patients and literature review

Treatment of fracture-related infection of the lower extremity with antibiotic-eluting ceramic bone substitutes: case series of 35 patients and literature review

Atypical fungal thoracic vertebral osteomylitis resembling metastatic tumor and literature review of fungal vertebral osteomylitis

Case report: Candida krusei spondylitis in an immunocompromised patient

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