Cervical Bone Graft Candida albicans Osteomyelitis: Management Strategies for an Uncommon Infection
Candida osteomyelitis in the current literature is an emerging infection. The factors contributing to its emergence include a growing population of immunosuppressed patients, invasive surgeries, broad-spectrum antibiotics, injection drug users, and alcohol abuse. The diagnosis requires a high degree...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2014/986393 |
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| author | Carlo Brembilla Luigi Andrea Lanterna Andrea Risso Giuseppe Bonaldi Paolo Gritti Bruno Resmini Andrea Viscone |
| author_facet | Carlo Brembilla Luigi Andrea Lanterna Andrea Risso Giuseppe Bonaldi Paolo Gritti Bruno Resmini Andrea Viscone |
| author_sort | Carlo Brembilla |
| collection | DOAJ |
| description | Candida osteomyelitis in the current literature is an emerging infection. The factors contributing to its emergence include a growing population of immunosuppressed patients, invasive surgeries, broad-spectrum antibiotics, injection drug users, and alcohol abuse. The diagnosis requires a high degree of suspicion. The insidious progression of infection and the nonspecificity of laboratory and radiologic findings may contribute to a delay in diagnosis. The current case concerns a 27-year-old man with a spinal cord injury who, after undergoing anterior cervical fixation and fusion surgery, developed postoperative systemic bacterial infection and required long-term antibiotic therapy. After six months, a CT scan demonstrated an almost complete anterior dislocation of the implants caused by massive bone destruction and reabsorption in Candida albicans infection. The patient underwent a second intervention consisting firstly of a posterior approach with C4–C7 fixation and fusion, followed by a second anterior approach with a corpectomy of C5 and C6, a tricortical bone grafting from the iliac crest, and C4–C7 plating. The antifungal therapy with fluconazole was effective without surgical debridement of the bone graft, despite the fact that signs of the bone graft being infected were seen from the first cervical CT scans carried out after one month. |
| format | Article |
| id | doaj-art-ea77931daf6947a681d3e2d571dd4e14 |
| institution | Kabale University |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-ea77931daf6947a681d3e2d571dd4e142025-02-03T06:08:12ZengWileyCase Reports in Orthopedics2090-67492090-67572014-01-01201410.1155/2014/986393986393Cervical Bone Graft Candida albicans Osteomyelitis: Management Strategies for an Uncommon InfectionCarlo Brembilla0Luigi Andrea Lanterna1Andrea Risso2Giuseppe Bonaldi3Paolo Gritti4Bruno Resmini5Andrea Viscone6Department of Neurosurgery, Pope John XXIII Hospital, WHO Square No. 1, 24100 Bergamo, ItalyDepartment of Neurosurgery, Pope John XXIII Hospital, WHO Square No. 1, 24100 Bergamo, ItalyDepartment of Neurosurgery, Pope John XXIII Hospital, WHO Square No. 1, 24100 Bergamo, ItalyDepartment of Neuroradiology, Pope John XXIII Hospital, WHO Square No. 1, 24100 Bergamo, ItalyDepartment of Anaesthesia and Intensive Care, Pope John XXIII Hospital, WHO Square No. 1, 24100 Bergamo, ItalyDepartment of Neurosurgery, Pope John XXIII Hospital, WHO Square No. 1, 24100 Bergamo, ItalyDepartment of Neurosurgery, Pope John XXIII Hospital, WHO Square No. 1, 24100 Bergamo, ItalyCandida osteomyelitis in the current literature is an emerging infection. The factors contributing to its emergence include a growing population of immunosuppressed patients, invasive surgeries, broad-spectrum antibiotics, injection drug users, and alcohol abuse. The diagnosis requires a high degree of suspicion. The insidious progression of infection and the nonspecificity of laboratory and radiologic findings may contribute to a delay in diagnosis. The current case concerns a 27-year-old man with a spinal cord injury who, after undergoing anterior cervical fixation and fusion surgery, developed postoperative systemic bacterial infection and required long-term antibiotic therapy. After six months, a CT scan demonstrated an almost complete anterior dislocation of the implants caused by massive bone destruction and reabsorption in Candida albicans infection. The patient underwent a second intervention consisting firstly of a posterior approach with C4–C7 fixation and fusion, followed by a second anterior approach with a corpectomy of C5 and C6, a tricortical bone grafting from the iliac crest, and C4–C7 plating. The antifungal therapy with fluconazole was effective without surgical debridement of the bone graft, despite the fact that signs of the bone graft being infected were seen from the first cervical CT scans carried out after one month.http://dx.doi.org/10.1155/2014/986393 |
| spellingShingle | Carlo Brembilla Luigi Andrea Lanterna Andrea Risso Giuseppe Bonaldi Paolo Gritti Bruno Resmini Andrea Viscone Cervical Bone Graft Candida albicans Osteomyelitis: Management Strategies for an Uncommon Infection Case Reports in Orthopedics |
| title | Cervical Bone Graft Candida albicans Osteomyelitis: Management Strategies for an Uncommon Infection |
| title_full | Cervical Bone Graft Candida albicans Osteomyelitis: Management Strategies for an Uncommon Infection |
| title_fullStr | Cervical Bone Graft Candida albicans Osteomyelitis: Management Strategies for an Uncommon Infection |
| title_full_unstemmed | Cervical Bone Graft Candida albicans Osteomyelitis: Management Strategies for an Uncommon Infection |
| title_short | Cervical Bone Graft Candida albicans Osteomyelitis: Management Strategies for an Uncommon Infection |
| title_sort | cervical bone graft candida albicans osteomyelitis management strategies for an uncommon infection |
| url | http://dx.doi.org/10.1155/2014/986393 |
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