Candida tropicalis osteomyelitis: Case report and review of literature

Shaikh, Zahirabanu; Shaikh, Shaukat; Pujol, Fernando; Trauber, David; Sam, Mirela

doi:10.1016/j.amjmed.2004.11.027

Cited by 13 publications

(7 citation statements)

References 14 publications

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“…As noted in the results section, extension of the CVO infection to the epidural, paraspinal space, or to the psoas muscle was observed in several patients; the most common extra-vertebral manifestation of infection was epidural abscess. This result was also noted in the literature patients [2,5,68,17,24,27,32,34,37,39,41,61,62]. Therefore, it is important to recognize the possibility of extraspinal manifestations of infection when considering treatment options.…”

Section: Figure 1 Outcomes Of Candida Vertebral Osteomyelitis Patiensupporting

confidence: 70%

Vertebral Osteomyelitis Due to <i>Candida</i> Species: A Cohort Study and Review of the Literature

Ramos¹,

Huddleston²,

Patel³

et al. 2013

OJO

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Objective: To describe the demographics and outcome of patients with candidal vertebral osteomyelitis (CVO). CVO is a rare and frequently misdiagnosed condition. It may lead to destruction of the vertebral bodies, spinal cord compression and neurological deficits. Methods: The medical records of all patients diagnosed with CVO at our institution between 01/01/1990-12/31/2009 were reviewed. The cumulative probability of treatment success was assessed by the Kaplan-Meier survival method. Patients were followed until death, failure, or loss of follow-up. Results: Nine patients developed CVO during the 20 year study period. The cervical spine was involved in 5 cases. Seven patients presented with mechanical-type pain, while 2 patients had an elevated temperature at diagnosis. A contiguous infection between the upper airways and the cervical spine was present in 4 patients. One patient presented with concomitant candidemia. Candida albicans, Candida parapsilosis, and Candida glabrata were cultured in 3 of 9 cases respectively. Eight of 9 were treated with azole-based therapy. Patients were followed for an average of 20 months (range 1-75 months). The cumulative incidence of success was 66% ± 19% at 1 year and 55% ± 20% at 2 years of follow-up. Conclusions: CVO presents insidiously and is associated with a long duration of symptoms. It most frequently affects the cervical spine and is associated with a poor outcome.

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Section: Figure 1 Outcomes Of Candida Vertebral Osteomyelitis Patiensupporting

confidence: 70%

Vertebral Osteomyelitis Due to <i>Candida</i> Species: A Cohort Study and Review of the Literature

Ramos¹,

Huddleston²,

Patel³

et al. 2013

OJO

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“…In 2005, Shaikh et al reviewed the literature on osteomyelitis caused by C. tropicalis and found 19 cases. 31 Of the 19 patients, 15 (79%) recovered, and none of them were infected by more than one Candida species.…”

Section: Literature Reviewmentioning

confidence: 96%

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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“…The type of fungal pathogen most frequently seen in vertebral osteomyelitis is "candida albicans". Less frequently seen strains are Candida tropicalis, Candida glabrata and Candida parapsilosis [8,13]. In vertebral osteomyelitis most affected bones are lumbar vertebrae.…”

Section: Discussionmentioning

confidence: 99%

“…They also might cause life threatening systemic infections through multiple organ failures resulting from septic shocks [5,6]. However, the frequency of bone and joint infection is low and vertebral osteomyelitis is rare [7][8][9][10]. Nevertheless, vertebral region is the most frequently affected area [11].…”

Section: Discussionmentioning

confidence: 99%

Bone scintigraphy in acute myeloid leukemia patient with fungal vertebral osteomyelitis

Hasbek¹,

Erselcan²,

Turgut³

et al. 2013

CMJ

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The result of the magnetic resonance imaging (MRI) study was reported as "metastasis of primary disease on L2-L3 vertebrae" in a 63-year-old male patient, who developed a back pain after receiving four courses of treatment for AML. The patient, who did not respond to pain medication, was sent to nuclear medicine department for a bone scintigraphy. Diffuse increased osteoblastic activity was reported on L2-L3 vertebrae with a suspicion about infection or fracture, together with a focal osteoblastic activity involvement in the right sacroiliac joint in the bone scintigraphy which was made with Tc99m-MDP. In the mean time, the patient complained about progressive loss of strength on bilateral lower extremities and numbness in legs. Repeated MRI was reported as "irregularities in L2-L3 vertebral disc region concordant with infection, prominent thecal pressure, loss of height in L2-L3 vertebrae associated with osteomyelitis and a mass concordant with paravertebral abscess and granulation tissue". The patient was operated and necrotic tissue was removed by curettage, relieving the compression on L2-L3 and on the disc distance. In culture examination of the sample "candida albicans" was isolated. Antifungal treatment with Amphotericin B was started. Patient's pain was reduced and MRI findings showed some regression in abscess following the treatment. There was improvement in neurological examination. However, relapse in AML was observed in bone marrow aspiration, performed during follow-up and chemotherapy was started again. On the second day of chemotherapy high fever started and cellulitis developed on the right leg. The patient received hemodialysis treatment due to increase in BUN and creatinine levels. Pulmonary edema and associated respiratory insufficiency was developed and the patient died. Fungal infections are one of the most important clinical problems in leukemia patients. However, vertebral osteomyelitis secondary to fungal infection is relatively a rare condition and delay in diagnosis and treatment may led to serious neurological problems. Suspection of a probable fungal infection by clinicians seems vital in such cases. Bone scintigraphy has no place in routine evaluation of leukemia patients. However, we consider that bone scintigraphy should be kept in mind in the first stage of evaluation of such cases, together with other radiological examination, we think that evaluation with consideration of three-phase bone scintigraphy would be beneficial.Keywords: Candida, acute myeloid leukemia, bone scintigraphy, vertebrae osteomyelitis ÖzetAkut miyeloid lösemi (AML) nedeni ile 4 kür tedavi aldıktan sonra, bel ağrısı gelişen 63 yaşındaki erkek hastada yapılan MR incelemesi raporu "L2-L3 vertebrada primer hastalığın metastazı" idi. Ağrı medikasyonlarına yanıt alınamayan hasta, nükleer tıp bölümüne kemik sintigrafisi için gönderildi. Tc-99m MDP ile yapılan kemik sintigrafisinde, enfeksiyon veya kırık şüphesi uyandıran, L2-L3 vertebralarda diffüz osteoblastik aktivite artışları bununla birlikte, sağ sakr...

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Candida tropicalis osteomyelitis: Case report and review of literature

Cited by 13 publications

References 14 publications

Vertebral Osteomyelitis Due to <i>Candida</i> Species: A Cohort Study and Review of the Literature

Vertebral Osteomyelitis Due to <i>Candida</i> Species: A Cohort Study and Review of the Literature

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

Bone scintigraphy in acute myeloid leukemia patient with fungal vertebral osteomyelitis

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Candida tropicalis osteomyelitis: Case report and review of literature

Cited by 13 publications

References 14 publications

Vertebral Osteomyelitis Due to &lt;i&gt;Candida&lt;/i&gt; Species: A Cohort Study and Review of the Literature

Vertebral Osteomyelitis Due to &lt;i&gt;Candida&lt;/i&gt; Species: A Cohort Study and Review of the Literature

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

Bone scintigraphy in acute myeloid leukemia patient with fungal vertebral osteomyelitis

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Vertebral Osteomyelitis Due to <i>Candida</i> Species: A Cohort Study and Review of the Literature

Vertebral Osteomyelitis Due to <i>Candida</i> Species: A Cohort Study and Review of the Literature