Septicemia due to Candida albicans: cerebral, ocular and vertebral localisations: successful treatment with three systemic antifungal agents

We report a case of spondylodiskitis, brain abcesses (on CT scan and magnet ic resonance imaging) and ocular localisation due to Candida albicans who w ere successfully treated with three antifungal agents: liposomal amphoteric ine B, fluconazole and flucytosine. Candidal spondylodiskitis was a late co mplication of candidemia. Clinical and radiological signs were non specific . Mortality associated with deep disseminated fungal infections has been re ported to be high due to delayed diagnosis and, until recently, a lack of e ffective and well-tolerated therapy. For several years amphotericin B has b een the drug of choice for fungal infections. However, its use has been lim ited by its renal toxicity. Encapsulation of amphotericin B into liposomes has been shown to reduce this toxicity and facilitates the use of larger an d more effective doses. Our patient had a favourable clinical response, the re were no evidence of antagonism with this triple combination.