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Hematogenous candida vertebral osteomyelitis treated with ketoconazole

Behandlung einer hämatogenen Candida-Wirbelosteomyelitis mit Ketoconazol

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Summary

Candida vertebral osteomyelitis was diagnosed in a patient with systemic lupus erythematodes following X-ray evidence of osteomyelitis and the repeated culturing ofCandida albicans from material obtained by needle biopsies from the third lumbar vertebra. The patient had been on glucocorticosteroids and parenteral nutrition six months previously. At that time, a yeast was cultured from the blood and the tip of the subclavian catheter which had been removed. After candida vertebral osteomyelitis was diagnosed, she was treated with ketoconazole for seven months. Recovery was impressive, as judged by the clinical and radiographic findings. At the time of writing this paper — 12 months after the withdrawal of ketoconazole — the patient showed no signs of recurrence.

Zusammenfassung

Bei einer Patientin mit systemischem Lupus erythematodes wurde röntgenologisch eine Wirbelosteomyelitis diagnostiziert. In Material, das durch Punktur des dritten Lendenwirbelkörpers gewonnen wurde, ließ sich kulturell wiederholtCandida albicans nachweisen. Sechs Monate vorher war die Patientin mit Kortikosteroiden behandelt und parenteral ernährt worden. Zu dieser Zeit wurden aus dem Blut und von der Spitze des entfernten Subclavia-Katheters Hefen kultiviert. Nachdem eine Wirbelosteomyelitis durchCandida diagnostiziert worden war, wurde die Patientin sieben Monate lang mit Ketoconazol behandelt. Entsprechend den klinischen und röntgenologischen Befunden kam es zu einem eindrucksvollen Heilungsverlauf. Zwölf Monate nach Beendigung der Ketoconazolbehandlung — zum Zeitpunkt der Manuskripterstellung — waren bei der Patientin keine Zeichen für einen Rückfall festzustellen.

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Authors and Affiliations

  1. Department of Infectious Diseases, University Hospital, Leiden, The Netherlands

    B. A. C. Dijkmans M. D., P. J. van den Broek M. D. & J. W. M. van der Meer M. D.

  2. Department of Nephrology, University Hospital, Leiden, The Netherlands

    M. I. Koolen M. D.

  3. Department of Medical Microbiology, University Hospital, Leiden, The Netherlands

    R. P. Mouton M. D.

  4. Department of Radiology, University Hospital, Leiden, The Netherlands

    T. H. M. Falke M. D.

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  1. B. A. C. Dijkmans M. D.
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  2. P. J. van den Broek M. D.
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  3. J. W. M. van der Meer M. D.
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  4. M. I. Koolen M. D.
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  5. R. P. Mouton M. D.
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  6. T. H. M. Falke M. D.
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Dijkmans, B.A.C., van den Broek, P.J., van der Meer, J.W.M. et al. Hematogenous candida vertebral osteomyelitis treated with ketoconazole. Infection 10, 290–292 (1982). https://doi.org/10.1007/BF01640877

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  • DOI: https://doi.org/10.1007/BF01640877

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