Candida vertebral osteomyelitis: A case report and review of the literature

Candida species are low virulence organisms which inhabit the skin and mucous membranes of most individuals. There has been increasing incidence of disseminated and deepseated Candida infections owing to the increasing number of immune compromised hosts. However, the Candida species are still rarely suggested as causative pathogens of vertebral osteomyelitis. We present a 51-year-old man with neck pain and cervical radiculopathy. Three months prior to visiting our hospital, he had undergone a urological operation which was complicated by a urinary tract infection. Magnetic resonance imaging and X-rays showed erosion of the body of the 5th cervical spine and collapse of the C5-C6 disc. After open debridement, tissue pathology results revealed Candida infection. Clinical stability was achieved during the 6-month follow-up period with a combination of amphotericin B and posterior fixation method. We reviewed the literature and found a high rate of surgical intervention for patients suggested of having Candida vertebral osteomyelitis. However, the surgical intervention may not be necessary. Early diagnosis using noninvasive percutaneous needle biopsy may help reduce the incidence of delayed treatment.