Vertebral osteomyelitis due to Candida spp.

INTRODUCTION. Vertebral osteomyelitis is rarely caused by Candida species; therefore, a high index of suspicion is required for its diagnosis. METHODS. We describe three cases of vertebral osteomyelitis due to Candida spp. diagnosed over a seventeen-year period. RESULTS. Among 110 episodes of vertebral osteomyelitis, three were caused by Candida spp. All three patients had risk factors for Candida infection: diabetes mellitus (2), immunosuppression (2), central venous catheters (3), antibiotic use (2) and parenteral nutrition (2). Radiographic studies and culture of vertebral specimens established the diagnosis in two patients. Blood cultures were positive in the third patient, who had aortic infectious endocarditis. Two of the three cases achieved clinical cure with medical treatment and the third relapsed after six months of therapy with fluconazole. CONCLUSION. Candidal vertebral osteomyelitis is an uncommon disease that should be suspected in patients with risk factors for candidemia.