Candida glabrata spinal osteomyelitis involving two contiguous lumbar vertebrae: a case report and review of the literature

Diagn Microbiol Infect Dis. 2003 Feb;45(2):137-41. doi: 10.1016/s0732-8893(02)00497-2.

Abstract

Due to the increase of the immunocompromised population, mucosal and systemic infections caused by Candida glabrata, formerly known as Torulopsis glabrata, have shown a recent significant increase. We present a case of C. glabrata vertebral osteomyelitis which required repeated surgical therapy, a complete L2 and L3 corporectomy and more than one year of hospitalisation to complete healing. We compare this case to eight previously reported cases outlining the features of C. glabrata spinal osteomyelitis, including symptoms, diagnosis, treatment, evolution and outcome. According to the case presented and in review of the literature, we believe that in the absence of abscess and neurologic symptoms, medical treatment should be initiated with close clinical, laboratory and radiologic follow-up. An unfavorable evolution of these parameters should be an indication for aggressive and, if necessary, repeated surgical intervention in association with an antifungal treatment.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B / therapeutic use
  • Candida glabrata* / pathogenicity
  • Candidiasis / diagnosis*
  • Candidiasis / surgery
  • Candidiasis / therapy*
  • Fluconazole / therapeutic use
  • Humans
  • Lumbar Vertebrae* / diagnostic imaging
  • Lumbar Vertebrae* / pathology
  • Male
  • Osteomyelitis / diagnosis*
  • Osteomyelitis / microbiology
  • Osteomyelitis / therapy*
  • Radiography

Substances

  • Amphotericin B
  • Fluconazole