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Management of destructive Candida albicans spondylodiscitis of the cervical spine: a systematic analysis of literature illustrated by an unusual case

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Abstract

Purpose

Candida induced spondylodiscitis of the cervical spine in immunocompetent patients is an extremely rare infectious complication. Since clinical symptoms might be nonspecific, therapeutic latency can lead to permanent spinal cord damage, sepsis and fatal complications. Surgical debridement is strongly recommended but there is no standard antimycotic regime for postsurgical treatment. This paper summarizes available data and demonstrates another successfully treated case.

Methods

The systematic analysis was performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. PubMed and Web of Science were scanned to identify English language articles. Additionally, the authors describe the case of a 60-year-old male patient who presented with a Candida albicans induced cervical spondylodiscitis after an edematous pancreatitis and C. albicans sepsis. Anterior cervical corpectomy and fusion of C4-C6, additional anterior plating, as well as posterior stabilization C3-Th1 was followed by a 6-month antimycotic therapy. There was neither funding nor conflict of interests.

Results

A systematic literature analysis was conducted and 4599 articles on spondylodiscitis were scanned. Only four cases were found reporting about a C. albicans spondylodiscitis in a non-immunocompromised patient. So far, our patient was followed up for 2 years. Until now, he shows free of symptoms and infection parameters. Standard testing for immunodeficiency showed no positive results.

Conclusion

Candida albicans spondylodiscitis of the cervical spine presents a potentially life-threatening disease. To our knowledge, this is the fifth case in literature that describes the treatment of C. albicans spondylodiscitis in an immunocompetent patient. Surgical debridement has to be considered, following antimycotic regime recommendations vary in pharmaceutical agents and treatment duration.

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Acknowledgements

The authors contracted with Michael S. Altus, PhD, ELS, of Intensive Care Communications, Inc., Baltimore, MD, USA, to edit their revised manuscript. The authors thank Dr Altus for his excellent services. The authors maintained complete control over the direction and content of the manuscript.

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Authors and Affiliations

  1. Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Waldeyerstraße 1, 48149, Münster, Germany

    Josef Stolberg-Stolberg, Steffen Roßlenbroich, Oliver Riesenbeck, Michael J. Raschke & René Hartensuer

  2. Department of Pharmacy, University Hospital Münster, Münster, Germany

    Dagmar Horn

  3. Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany

    Michael Mohr

  4. Institute of Hygiene, University Hospital Münster, Münster, Germany

    Stefanie Kampmeier

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  1. Josef Stolberg-Stolberg
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Correspondence to Josef Stolberg-Stolberg.

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Stolberg-Stolberg, J., Horn, D., Roßlenbroich, S. et al. Management of destructive Candida albicans spondylodiscitis of the cervical spine: a systematic analysis of literature illustrated by an unusual case. Eur Spine J 26, 1009–1018 (2017). https://doi.org/10.1007/s00586-016-4827-3

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  • DOI: https://doi.org/10.1007/s00586-016-4827-3

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