TY - JOUR
T1 - Bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei: a case report and an updated literature review
AU - Kaldau, Niels Christian
AU - Brorson, Stig
AU - Jensen, Poul Einar
AU - Schultz, Charlotte
AU - Arpi, Rolf Magnus
N1 - © 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
PY - 2012/1
Y1 - 2012/1
N2 - Objectives: We present a case of bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei, and review the literature on Candida osteomyelitis. Methods: PubMed was searched for cases of Candida osteomyelitis published in the English-language literature between 1970 and 2010. Case: A 60-year-old previously healthy man was hospitalized with gallstone pancreatitis. Between 3 weeks and 6 months after hospitalization, he developed bilateral osteomyelitis of the feet with C. tropicalis and C. krusei. The patient was treated with surgery, fluconazole, and a liposomal formulation of amphotericin B. The left lower limb was amputated, and at a 2-year follow-up, the patient had almost no pain in his right foot. Literature review: We identified 40 new cases in the literature since the latest review in 2004. Most cases of Candida osteomyelitis are caused by Candida albicans, but an increasing number are caused by non-albicans species. The prognosis is favorable, with full recovery in the majority of cases. Conclusions: 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.
AB - Objectives: We present a case of bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei, and review the literature on Candida osteomyelitis. Methods: PubMed was searched for cases of Candida osteomyelitis published in the English-language literature between 1970 and 2010. Case: A 60-year-old previously healthy man was hospitalized with gallstone pancreatitis. Between 3 weeks and 6 months after hospitalization, he developed bilateral osteomyelitis of the feet with C. tropicalis and C. krusei. The patient was treated with surgery, fluconazole, and a liposomal formulation of amphotericin B. The left lower limb was amputated, and at a 2-year follow-up, the patient had almost no pain in his right foot. Literature review: We identified 40 new cases in the literature since the latest review in 2004. Most cases of Candida osteomyelitis are caused by Candida albicans, but an increasing number are caused by non-albicans species. The prognosis is favorable, with full recovery in the majority of cases. Conclusions: 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.
U2 - 10.1016/j.ijid.2011.10.001
DO - 10.1016/j.ijid.2011.10.001
M3 - Journal article
SN - 1201-9712
VL - 16
SP - e16-22
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
IS - 1
ER -