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Medicina Clinica 1993-Mar

[Candida albicans spondylodiscitis].

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J de la Torre Lima
M E Jiménez-Mejías
J L de Francisco
V Martín-Sanz
J M Viciana Fernández
E Cañas García-Otero

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Infections by Candida sp. have increased notably and cause not only local but also systemic infections. It is rarely mentioned as an etiologic agent of osteomyelitis. Two cases of candidiasic spondylodiscitis are presented with the first being in a 33 year old intravenous drug using male who consulted for mechanical lumbar pain. Spondylodiscitis L2-L3 was observed upon radiological study. Aspiration puncture was carried out and the cultures were negative. Surgical biopsy was performed with spondylodiscitis and an abscess in the spine being observed. C. albicans was isolated in the culture. Pathological study confirmed the diagnosis. Cutaneous and sternocostal involvement was also concommitantly presented. The patient was treated with amphotericin B with a favorable evolution. The second case was in a 35 year old male with burns over 65% of his body due to a laboral accident. Three months after admission the patient presented lumbar pain irradiating to the groin and thigh. Bone destruction of the second lumbar vertebra and an abscess of the right psoas were observed upon CT scan. Puncture biopsy was performed and C. albicans was isolated. Histopathologic study demonstrated osteomyelitis by Candida sp. Treatment with amphotericin B was started. Posteriorly urea and creatinine was raised. Treatment was continued with fluconazole with good therapeutic response.

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