pp 1–4 | Cite as

Vertebral osteomyelitis due to Candida species

  • Nathan McLeodEmail author
  • Melanie Fisher
  • P. Rocco Lasala
Brief Report



We have noted an increased number of cases of vertebral osteomyelitis secondary to Candida species over the past few years at our facility. Our aim was to identify and review these cases to elucidate risk factors, treatment regimens and outcomes.


We performed a retrospective chart review using our electronic medical record and microbiology laboratory database to identify cases of vertebral osteomyelitis due to Candida at a single teaching hospital from 2006–2018.


We found 15 cases of Candida vertebral osteomyelitis. The majority of cases were due to Candida albicans and affected either the lumbar or the thoracic spine. Injection drug use and previous spine surgery were the two most common risk factors identified. Treatment was largely with intravenous antifungal induction followed by prolonged therapy with oral fluconazole. There was no short-term mortality though we lacked long-term follow-up on most patients.


The number of vertebral infections due to Candida may be increasing. This may be partially driven by both a rise in intravenous drug use as well as the growing rate of spine surgery. Management following currently available guidelines seems favorable, though further studies are necessary to determine the optimal treatment regimen.


Candida Vertebral osteomyelitis Diskitis Injection drug use Candida infections 




Compliance with ethical standards

Conflict of interest

The authors have no competing interest.

Ethical approval

West Virginia University Institutional Review Board approved this study.

Informed consent

No informed consent was required due to the retrospective nature of this study and no patient identifying information was utilized in this publication.


  1. 1.
    Miller DJ, Mejicano GC. Vertebral osteomyelitis due to candida species: case report and literature review. Clin Infect Dis. 2001;33:523–30.CrossRefGoogle Scholar
  2. 2.
    Gamaletsou MN, Kontoyiannis DP, Sipsas NV, et al. Candida osteomyelitis: analysis of 207 pediatric and adult cases (1970–2011). Clin Infect Dis. 2012;55(10):1338–51.CrossRefGoogle Scholar
  3. 3.
    Hendrickx L, Van Wijingaerden E, Samson I, Peetermans WE. Candidal vertebral osteomyelitis: report of 6 patients, and a review. Clin Infect Dis. 2001;32:527–33.CrossRefGoogle Scholar
  4. 4.
    National Institute on Drug Abuse. West Virginia opioid summary. NIDA. Accessed 28 Feb 2018.
  5. 5.
    Pappas PG, Kauffman CA, Andes DR, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1–50.CrossRefGoogle Scholar
  6. 6.
    Berbari EF, Kanj SS, Kowalski TJ, et al. 2015 Infectious Diseases Society of America clinical practice guidelines for the management of native vertebral osteomyelitis. Clin Infect Dis. 2015;61(6):e26–46.CrossRefGoogle Scholar
  7. 7.
    Cone LA, Byrd RG, Potts BE, Wuestoff M. Diagnosis and treatment of candida vertebral osteomyelitis: clinical experience with a short course of therapy of amphotericin B lipid complex. Surg Neurol. 2004;62:234–7.CrossRefGoogle Scholar
  8. 8.
    Storm L, Lausch KR, Arendrup MC, et al. Vertebral infection with candida albicans failing caspofungin and fluconazole combination therapy but successfully treated with high dose liposomal amphotericin B and flucytosine. Med Mycol Case Rep. 2004;6:6–9.CrossRefGoogle Scholar
  9. 9.
    Friedman BC, Simon GL. Candida vertebral osteomyelitis: report of three cases and a review of the literature. Diagn Microbiol Infect Dis. 1987;8:31–6.CrossRefGoogle Scholar
  10. 10.
    Gafter-Gvili A, Vidal L, Goldberg E, Leibovici L, Paul M Treatment of invasive candidal infections: systematic review and meta-analysis. Mayo Clin Proc. 2008; 83(9):1011CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Medicine, Section of Infectious DiseasesWest Virginia University School of MedicineMorgantownUSA
  2. 2.Department of Pathology and Laboratory MedicineWest Virginia University School of MedicineMorgantownUSA

Personalised recommendations