TREATMENT FOR CANDIDA-ALBICANS SPINAL INF ECTIONS - A REPORT ON 2 CASES AND LITERATURE-REVIEW

Candida albicans spinal infections remain rare. Therapeutic protocol i n that setting is not well defined. We report two new cases, including a sacroiliitis. Flucytosine and amphotericin B were used in both case s. In one case, itraconazole and then fluconazole were added. Availabl e drugs were amphotericin B, flucytosine, and azole antifungal agents. Some data can be found on the distribution of flucytosine and flucona zole in bones. With the latter compound, a high dosage (600-800 mg/d i n adults) should be used to treat osteoarticular infections. A review of French and English literature is presented and therapeutic guidelin es are submitted. One of our cases illustrates how difficult the steri lisation of an osteoarticular septic metastasis may be for candidemia. Dosage higher than the standard 400 mg/d of fluconazole should be con sidered in the treatment of candidemia.