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KMID : 1146020100030020123
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Journal of Critical Spine Cases
2010 Volume.3 No. 2 p.123 ~ p.126
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Successful Use of Amphotericin B-impregnated Bone Cement Vertebroplasty to Treat Spinal Osteomyelitis Caused by Candida Albicans
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Wu Meng-Ting
Tsuei Yuang-Seng
Hu Tzer-Liang
Shen Chiung-Chyi
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Abstract
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A case report of vertebral osteomyelitis due to Candida albicans (C. albicans) was secondary to antibiotics treatment of pancreatitis. Fungal pathogens are recognized as a po-tential cause of osteomyelitis. We describe a case of fungal vertebral osteomyelitis with treatment of amphotericin B-impregnated bone cement has apparently not been previously reported in the literature. A middle-aged man presenting with clinical and radiologic imaging evidence of pancreatitis underwent percutaneous drainage with antibiotic treatment. Five months later, he presented with worsened low back pain, elevated serum acute phase reactants, and plain radiographic evidence of L4-5 infective discitis and ver-tebral osteomyelitis involving L4-5 level. Magnetic resonance imaging (MRI) and microbiologic examination of the specimens by tomography-guided biopsy confirmed infective discitis involving L4-5 intervertebral level. The patient was successfully treated with vertebroplasty of amphotericin B-impregnated bone cement and antibiotic targeted at C. albicans, which was isolated in the culture of the biopsy specimens. Follow-up improvements in the clinical condition, serum acute phase reactants levels, radiographs, and MRI were noted. Vertebral osteomyelitis infected by C. albicans with the treatement of vertebroplasty with amphotericin B-impregnated bone cement is a effective way to control the infection. We believe this is the first report of such treatment for fungal vertebral osteomyelitis.
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KEYWORD
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Osteomyelitis, Candida, Cement, Vertebroplasty
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