SPONDYLODISCITIS BY CANDIDA-ALBICANS

Infections by Candida sp. have increased notably and cause not only lo cal but also systemic infections. It is rarely mentioned as an etiolog ic agent of osteomyelitis. Two cases of candidiasic spondylodiscitis a re presented with the first being in a 33 year old intravenous drug us ing male who consulted for mechanical lumbar pain. Spondylodiscitis L2 -L3 was observed upon radiological study. Aspiration puncture was carr ied out and the cultures were negative. Surgical biopsy was performed with spondylodiscitis and an abscess in the spine being observed. C. a lbicans was isolated in the culture. Pathological study confirmed the diagnosis. Cutaneous and sternocostal involvement was also concommitan tly presented. The patient was treated with amphotericin B with a favo rable evolution. The second case was in a 35 year old male with burns over 65 % of his body due to a laboral accident. Three months after ad mission the patient presented lumbar pain irradiating to the groin and thigh. Bone destruction of the second lumbar vertebra and an abscess of the right psoas were observed upon CT scan. Puncture biopsy was per formed and C. albicans was isolated. Histopathologic study demonstrate d osteomyelitis by Candida sp. Treatment with amphotericin B was start ed. Posteriorly urea and creatinine was raised. Treatment was continue d with fluconazole with good therapeutic response.