Two hundred and eleven cases of Candida osteomyelitis: 17 case reports and a review of the literature

Diagn Microbiol Infect Dis. 2012 May;73(1):89-93. doi: 10.1016/j.diagmicrobio.2012.02.004.

Abstract

Candida osteomyelitis is a rare infection. We present 17 cases of Candida osteomyelitis from our institution and review 194 patients from the literature. The median age of patients was 57 ± 22 years (range, 18-90 years) with 68% male. Comorbidities associated with this infection include prior surgery (62%), broad-spectrum antibiotics (40%), central venous catheter insertion (19%), and immunosuppression (17%). The most common infecting species were Candida albicans (69%), Candida tropicalis (15%), and Candida glabrata (8%). Most initial antifungal regimens included amphotericin B (59%); however, fluconazole is increasingly being utilized for treatment of this infection (26%). Echinocandins were used infrequently (4%). Median length of treatment was 3 ± 4.5 months (mean, 4.2 months; range, 18 days to 36 months). The overall success rate of therapy was 91%, with 75% of patients cured by 6 months. The crude mortality rate was 12% with an attributable mortality rate of 6%.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Amphotericin B / administration & dosage
  • Antifungal Agents / administration & dosage
  • Candida / classification*
  • Candida / isolation & purification*
  • Candidiasis / drug therapy
  • Candidiasis / epidemiology
  • Candidiasis / microbiology*
  • Candidiasis / pathology*
  • Comorbidity
  • Echinocandins / administration & dosage
  • Female
  • Fluconazole / administration & dosage
  • Humans
  • Male
  • Middle Aged
  • Osteomyelitis / drug therapy
  • Osteomyelitis / epidemiology
  • Osteomyelitis / microbiology*
  • Osteomyelitis / pathology*
  • Risk Factors
  • Sex Distribution
  • Treatment Outcome
  • Young Adult

Substances

  • Antifungal Agents
  • Echinocandins
  • Amphotericin B
  • Fluconazole