Nathan McLeod1, Melanie Fisher2, P Rocco Lasala3. 1. Department of Medicine, Section of Infectious Diseases, West Virginia University School of Medicine, Morgantown, West Virginia, USA. ndm0011@hsc.wvu.edu. 2. Department of Medicine, Section of Infectious Diseases, West Virginia University School of Medicine, Morgantown, West Virginia, USA. 3. Department of Pathology and Laboratory Medicine, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
Abstract
OBJECTIVE: We have noted an increased number of cases of vertebral osteomyelitis secondary to Candida species over the past few years at our facility. Our aim was to identify and review these cases to elucidate risk factors, treatment regimens and outcomes. METHODS: We performed a retrospective chart review using our electronic medical record and microbiology laboratory database to identify cases of vertebral osteomyelitis due to Candida at a single teaching hospital from 2006-2018. RESULTS: We found 15 cases of Candida vertebral osteomyelitis. The majority of cases were due to Candida albicans and affected either the lumbar or the thoracic spine. Injection drug use and previous spine surgery were the two most common risk factors identified. Treatment was largely with intravenous antifungal induction followed by prolonged therapy with oral fluconazole. There was no short-term mortality though we lacked long-term follow-up on most patients. CONCLUSIONS: The number of vertebral infections due to Candida may be increasing. This may be partially driven by both a rise in intravenous drug use as well as the growing rate of spine surgery. Management following currently available guidelines seems favorable, though further studies are necessary to determine the optimal treatment regimen.
OBJECTIVE: We have noted an increased number of cases of vertebral osteomyelitis secondary to Candida species over the past few years at our facility. Our aim was to identify and review these cases to elucidate risk factors, treatment regimens and outcomes. METHODS: We performed a retrospective chart review using our electronic medical record and microbiology laboratory database to identify cases of vertebral osteomyelitis due to Candida at a single teaching hospital from 2006-2018. RESULTS: We found 15 cases of Candida vertebral osteomyelitis. The majority of cases were due to Candida albicans and affected either the lumbar or the thoracic spine. Injection drug use and previous spine surgery were the two most common risk factors identified. Treatment was largely with intravenous antifungal induction followed by prolonged therapy with oral fluconazole. There was no short-term mortality though we lacked long-term follow-up on most patients. CONCLUSIONS: The number of vertebral infections due to Candida may be increasing. This may be partially driven by both a rise in intravenous drug use as well as the growing rate of spine surgery. Management following currently available guidelines seems favorable, though further studies are necessary to determine the optimal treatment regimen.
Entities:
Keywords:
Candida; Candida infections; Diskitis; Injection drug use; Vertebral osteomyelitis
Authors: Basem Ishak; Amir Abdul-Jabbar; Gregory B Moss; Emre Yilmaz; Alexander von Glinski; Sven Frieler; Andreas W Unterberg; Ronan Blecher; Juan Altafulla; Jeffrey Roh; Robert A Hart; Rod J Oskouian; Jens R Chapman Journal: Neurosurg Rev Date: 2020-08-27 Impact factor: 3.042