Case report: Candida krusei spondylitis in an immunocompromised patient

BMC Infect Dis. 2020 Oct 8;20(1):739. doi: 10.1186/s12879-020-05451-3.

Abstract

Background: Invasive infections with Candida krusei are uncommon and rarely complicated by spondylitis. Previous described cases were solely treated with antimycotic therapy, despite guidelines recommending surgical interventions.

Case presentation: We describe a case of C. krusei spondylitis in a patient treated with chemotherapy for acute myeloid leukemia. After induction chemotherapy, the patient developed a candidemia, which was treated with micafungin. One month after the candidemia, the patient was admitted with severe lumbar pain. Spondylitis of the L4 and L5 vertebra was diagnosed on MR-imaging, with signs suggesting an atypical infection. The patient was treated with anidulafungin combined with voriconazole. Despite maximal conservative management symptoms gradually worsened eventually requiring surgical intervention.

Conclusions: In contrast to previous case reports, antimycotic treatment alone could be insufficient in treating C. krusei spondylitis.

Keywords: Candida krusei; Candidemia; Spondylitis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anidulafungin / therapeutic use
  • Antifungal Agents / therapeutic use
  • Candida / drug effects*
  • Candidemia / chemically induced
  • Candidemia / drug therapy
  • Candidiasis / drug therapy
  • Candidiasis / immunology*
  • Candidiasis / microbiology
  • Candidiasis / surgery
  • Humans
  • Immunocompromised Host*
  • Induction Chemotherapy / adverse effects
  • Male
  • Micafungin / therapeutic use
  • Spondylitis / drug therapy*
  • Spondylitis / immunology*
  • Spondylitis / microbiology
  • Spondylitis / surgery
  • Treatment Outcome
  • Voriconazole / therapeutic use

Substances

  • Antifungal Agents
  • Anidulafungin
  • Voriconazole
  • Micafungin