Candida osteomyelitis: report of five cases and review of the literature

Candida species have emerged as important pathogens in human infection. Although a variety of deep-seated candidal infections have been reported, Candida osteomyelitis has rarely been described. Five patients with Candida osteomyelitis are presented, and the 32 adult cases previously reported are re...

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Published inThe American journal of medicine Vol. 82; no. 5; pp. 927 - 937
Main Authors GATHE, J. C. JR, HARRIS, R. L, GARLAND, B, BRADSHAW, M. W, WILLIAMS, T. W. JR
Format Journal Article
LanguageEnglish
Published New York, NY Elsevier 01.05.1987
Subjects
Aged
Antifungal Agents - therapeutic use
Biological and medical sciences
Candidiasis - diagnosis
Candidiasis - drug therapy
Human mycoses
Humans
Infectious diseases
Male
Medical sciences
Middle Aged
Mycoses
Mycoses of the osteoarticular system
Osteomyelitis - diagnosis
Osteomyelitis - drug therapy
Fungi
Infection
Mycosis
Candida
Osteitis
Fungi Imperfecti
Thallophyta
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Summary:Candida species have emerged as important pathogens in human infection. Although a variety of deep-seated candidal infections have been reported, Candida osteomyelitis has rarely been described. Five patients with Candida osteomyelitis are presented, and the 32 adult cases previously reported are reviewed. Candida osteomyelitis is noted as a simultaneous occurrence or late manifestation of hematogenously disseminated candidiasis. Osteomyelitis may not be prevented by a course of amphotericin B adequate to control the acute episode of disseminated candidiasis, particularly in immunosuppressed patients. Less commonly, Candida osteomyelitis presents as a postoperative wound infection. Like bacterial osteomyelitis, the most common presenting symptom is local pain. The insidious progression of infection, the nonspecificity of laboratory data, and the failure to recognize Candida as a potential pathogen may lead to diagnostic delay. Diagnosis can be made by either open biopsy or closed needle aspiration. Successful therapeutic regimens have employed combinations of antifungal therapy (most often amphotericin B) with surgical debridement when indicated. It is anticipated that osteomyelitis will become a more commonly recognized manifestation of hematogenously disseminated candidiasis.
Bibliography:ObjectType-Case Study-3
SourceType-Scholarly Journals-1
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ObjectType-Review-1
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ISSN:0002-9343
1555-7162
DOI:10.1016/0002-9343(87)90154-9