Chia S L, Tan B H, Tan C T, Tan S B
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
J Infect. 2005 Jul;51(1):17-23. doi: 10.1016/j.jinf.2004.08.020.
Epidural abscess associated with candidal spondylodiscitis is rarely seen, particularly when it involves the cervical and thoracic spine. We report two such cases that were successfully managed with early surgical debridement, as well as medical therapy with intravenous amphotericin followed by oral fluconazole. The literature related to candidal spinal infection is reviewed, and a rational approach to the management of this uncommon condition is proposed. A good outcome may generally be expected with early diagnosis as well as appropriate surgical and pharmacological treatment. Oral fluconazole appears to be useful in the management of candida spondylodiscitis complicated by epidural abscess formation. Treatment until a normal ESR is attained is ideal, and this may be as short as 3 months when surgical drainage has been adequately performed.
与念珠菌性脊椎椎间盘炎相关的硬膜外脓肿很少见，尤其是累及颈椎和胸椎时。我们报告了两例通过早期手术清创以及静脉注射两性霉素随后口服氟康唑进行药物治疗而成功治愈的病例。对与念珠菌性脊柱感染相关的文献进行了综述，并提出了针对这种罕见病症的合理治疗方法。早期诊断以及适当的手术和药物治疗通常有望取得良好效果。口服氟康唑似乎对治疗并发硬膜外脓肿形成的念珠菌性脊椎椎间盘炎有用。理想的治疗是持续到血沉恢复正常，当已充分进行手术引流时，治疗时间可能短至3个月。
