Experimental and Clinical Medicine Department, Division of Internal Medicine, AOU Careggi, Florence, Italy.
Experimental and Clinical Medicine Department, Division of Internal Medicine, AOU Careggi, Florence, Italy.
Int J Infect Dis. 2018 Mar;68:31-35. doi: 10.1016/j.ijid.2018.01.003. Epub 2018 Jan 12.
Spondylodiscitis is an infection of the vertebral column, the incidence of which is increasing due to an increase in the susceptible population and improved ascertainment. This disease has been associated with a wide range of microorganisms. Fungal spondylodiscitis is uncommon (0.5-1.6%) and strongly associated with immunosuppression and diabetes (Gouliouris et al., 2010). A rare case of Candida glabrata spondylodiscitis in a non-neutropenic diabetic patient is reported herein, along with a review of the literature.
A case of C. glabrata spondylodiscitis of L3-L4 metameres was diagnosed. The diagnosis was obtained through open biopsy of an abscess and culture examination. The patient was treated with anidulafungin and surgical debridement of the lesion.
The diagnosis of spondylodiscitis is often delayed or missed. Physicians should consider this entity in the differential diagnosis of lumbar pain in order to initiate an appropriate therapy to prevent spinal cord lesions and disability. This is particularly relevant in the case of a fungal aetiology, as there is a recognized global shift towards invasive candidiasis due to non-albicans Candida species, in particular C. glabrata, which has variable susceptibility to antifungal drugs.
脊椎炎是一种脊柱感染，由于易感人群的增加和检测水平的提高，其发病率正在上升。这种疾病与多种微生物有关。真菌性脊椎炎并不常见（0.5-1.6%），与免疫抑制和糖尿病密切相关（Gouliouris 等人，2010 年）。本文报告了一例非中性粒细胞减少症糖尿病患者罕见的光滑假丝酵母菌脊椎炎，并对文献进行了回顾。
诊断为 L3-L4 节段的光滑假丝酵母菌脊椎炎。通过脓肿的开放性活组织检查和培养检查获得诊断。患者接受安尼达非尼治疗和病变的手术清创。
脊椎炎的诊断常常被延迟或遗漏。医生应在腰椎疼痛的鉴别诊断中考虑到这种情况，以便启动适当的治疗以预防脊髓损伤和残疾。对于真菌性病因，这一点尤为重要，因为由于非白念珠菌假丝酵母菌，尤其是光滑假丝酵母菌，对抗真菌药物的敏感性存在差异，全球侵袭性念珠菌病的发病率呈公认的上升趋势。
