Tratamiento de osteomielitis vertebral por Candida spp. con caspofungina. Presentación de un caso y revisión de la bibliografía
Abstract: Introduction: Vertebral osteomyelitis (VO) by non-albicans Candida species is an infrequent type of osteomyelitis, however, its incidence has increased due to the increasing number of immunosuppressed patients and invasive procedures. Candida spp is more frequently resistant to azole antif...
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Universidad del Zulia,Facultad de Medicina,Departamento de Enfermedades Infecciosas y Tropicales
2005
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ftdoajarticles:oai:doaj.org/article:730bbeaa9f154b6ba902a7730d754840 2023-10-01T03:54:22+02:00 Tratamiento de osteomielitis vertebral por Candida spp. con caspofungina. Presentación de un caso y revisión de la bibliografía Arocha Francisco Espinoza Fabiola Lizcano Pastor Parra Katynna Bracho, Annelly 2005-12-01T00:00:00Z https://doaj.org/article/730bbeaa9f154b6ba902a7730d754840 EN ES eng spa Universidad del Zulia,Facultad de Medicina,Departamento de Enfermedades Infecciosas y Tropicales https://drive.google.com/file/d/1-AYv4ErtIShGUQH_Lxb2Bitn4laxIF7w/view https://doaj.org/toc/0075-5222 https://doaj.org/toc/2477-9628 0075-5222 2477-9628 https://doaj.org/article/730bbeaa9f154b6ba902a7730d754840 Kasmera, Vol 33, Iss 1, Pp 64-73 (2005) Vertebral osteomyelitis Candida spp Caspofungin Osteomielitis vertebral caspofungina Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2005 ftdoajarticles 2023-09-03T00:47:51Z Abstract: Introduction: Vertebral osteomyelitis (VO) by non-albicans Candida species is an infrequent type of osteomyelitis, however, its incidence has increased due to the increasing number of immunosuppressed patients and invasive procedures. Candida spp is more frequently resistant to azole antifungal drugs, such as fluconazole, than Candida albicans. Methods: We report one case of a 75-year-old diabetic male, with low back pain radiated to both legs, tenderness, and fever 3 weeks after an epidural anesthesia for prostatectomy. Results: VO diagnosis was supported by lumbosacral magnetic resonance imaging (RMI), which showed osteolitic lesions in the L4-L5 spine and the intervertebral disk. Surgical drainage was performed, with a sample for culture yielding Candida spp. The patient was treated with on I.V fluconazole 400 mg per day. Symptoms persisted 15 days later; the erythrocyte sedimentation rate (ESR) was elevated, the C-reactive protein was positive and there was purulent secretion in the surgical wound. A new lumbosacral spine MRI still showed vertebral osteomyelitis and a paravertebral abscess. The patient underwent a new surgical debridement and the sample for culture yielded a heavy growth of Candida spp. In view of the clinical and microbiologic treatment failure, the patient was placed on iv caspofungin 50 mg daily. The patient became asymptomatic after 10 days of treatment; the ESR decreased to 5 mm and the C-reactive protein was negative; therefore, treatment was switched to 200 mg of itraconazole for 3 months. A follow-up MRI showed a L4-L5 spine fusion with no evidence of osteomyelitis. Conclusions: Few cases of epidural blockage related to vertebral osteomyelitis was found in the reviewed literature and this is the only case due to Candida. The percentage of fluconazole-resistant C. tropicalis isolates is low but when no-albicans Candida fluconazole resistance emerges, alternatives such as amphotericin B and caspofungin have to be used. Caspofungin was chosen in this case due to the patient□s ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic |
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Directory of Open Access Journals: DOAJ Articles |
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English Spanish |
topic |
Vertebral osteomyelitis Candida spp Caspofungin Osteomielitis vertebral caspofungina Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Vertebral osteomyelitis Candida spp Caspofungin Osteomielitis vertebral caspofungina Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Arocha Francisco Espinoza Fabiola Lizcano Pastor Parra Katynna Bracho, Annelly Tratamiento de osteomielitis vertebral por Candida spp. con caspofungina. Presentación de un caso y revisión de la bibliografía |
topic_facet |
Vertebral osteomyelitis Candida spp Caspofungin Osteomielitis vertebral caspofungina Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Abstract: Introduction: Vertebral osteomyelitis (VO) by non-albicans Candida species is an infrequent type of osteomyelitis, however, its incidence has increased due to the increasing number of immunosuppressed patients and invasive procedures. Candida spp is more frequently resistant to azole antifungal drugs, such as fluconazole, than Candida albicans. Methods: We report one case of a 75-year-old diabetic male, with low back pain radiated to both legs, tenderness, and fever 3 weeks after an epidural anesthesia for prostatectomy. Results: VO diagnosis was supported by lumbosacral magnetic resonance imaging (RMI), which showed osteolitic lesions in the L4-L5 spine and the intervertebral disk. Surgical drainage was performed, with a sample for culture yielding Candida spp. The patient was treated with on I.V fluconazole 400 mg per day. Symptoms persisted 15 days later; the erythrocyte sedimentation rate (ESR) was elevated, the C-reactive protein was positive and there was purulent secretion in the surgical wound. A new lumbosacral spine MRI still showed vertebral osteomyelitis and a paravertebral abscess. The patient underwent a new surgical debridement and the sample for culture yielded a heavy growth of Candida spp. In view of the clinical and microbiologic treatment failure, the patient was placed on iv caspofungin 50 mg daily. The patient became asymptomatic after 10 days of treatment; the ESR decreased to 5 mm and the C-reactive protein was negative; therefore, treatment was switched to 200 mg of itraconazole for 3 months. A follow-up MRI showed a L4-L5 spine fusion with no evidence of osteomyelitis. Conclusions: Few cases of epidural blockage related to vertebral osteomyelitis was found in the reviewed literature and this is the only case due to Candida. The percentage of fluconazole-resistant C. tropicalis isolates is low but when no-albicans Candida fluconazole resistance emerges, alternatives such as amphotericin B and caspofungin have to be used. Caspofungin was chosen in this case due to the patient□s ... |
format |
Article in Journal/Newspaper |
author |
Arocha Francisco Espinoza Fabiola Lizcano Pastor Parra Katynna Bracho, Annelly |
author_facet |
Arocha Francisco Espinoza Fabiola Lizcano Pastor Parra Katynna Bracho, Annelly |
author_sort |
Arocha Francisco |
title |
Tratamiento de osteomielitis vertebral por Candida spp. con caspofungina. Presentación de un caso y revisión de la bibliografía |
title_short |
Tratamiento de osteomielitis vertebral por Candida spp. con caspofungina. Presentación de un caso y revisión de la bibliografía |
title_full |
Tratamiento de osteomielitis vertebral por Candida spp. con caspofungina. Presentación de un caso y revisión de la bibliografía |
title_fullStr |
Tratamiento de osteomielitis vertebral por Candida spp. con caspofungina. Presentación de un caso y revisión de la bibliografía |
title_full_unstemmed |
Tratamiento de osteomielitis vertebral por Candida spp. con caspofungina. Presentación de un caso y revisión de la bibliografía |
title_sort |
tratamiento de osteomielitis vertebral por candida spp. con caspofungina. presentación de un caso y revisión de la bibliografía |
publisher |
Universidad del Zulia,Facultad de Medicina,Departamento de Enfermedades Infecciosas y Tropicales |
publishDate |
2005 |
url |
https://doaj.org/article/730bbeaa9f154b6ba902a7730d754840 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Kasmera, Vol 33, Iss 1, Pp 64-73 (2005) |
op_relation |
https://drive.google.com/file/d/1-AYv4ErtIShGUQH_Lxb2Bitn4laxIF7w/view https://doaj.org/toc/0075-5222 https://doaj.org/toc/2477-9628 0075-5222 2477-9628 https://doaj.org/article/730bbeaa9f154b6ba902a7730d754840 |
_version_ |
1778521921606909952 |