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Soriano A, Honore PM, Puerta-Alcalde P, Garcia-Vidal C, Pagotto A, Gonçalves-Bradley DC, Verweij PE. Invasive candidiasis: current clinical challenges and unmet needs in adult populations. J Antimicrob Chemother 2023:7176280. [PMID: 37220664 DOI: 10.1093/jac/dkad139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Invasive candidiasis (IC) is a serious infection caused by several Candida species, and the most common fungal disease in hospitals in high-income countries. Despite overall improvements in health systems and ICU care in the last few decades, as well as the development of different antifungals and microbiological techniques, mortality rates in IC have not substantially improved. The aim of this review is to summarize the main issues underlying the management of adults affected by IC, focusing on specific forms of the infection: IC developed by ICU patients, IC observed in haematological patients, breakthrough candidaemia, sanctuary site candidiasis, intra-abdominal infections and other challenging infections. Several key challenges need to be tackled to improve the clinical management and outcomes of IC patients. These include the lack of global epidemiological data for IC, the limitations of the diagnostic tests and risk scoring tools currently available, the absence of standardized effectiveness outcomes and long-term data for IC, the timing for the initiation of antifungal therapy and the limited recommendations on the optimal step-down therapy from echinocandins to azoles or the total duration of therapy. The availability of new compounds may overcome some of the challenges identified and increase the existing options for management of chronic Candida infections and ambulant patient treatments. However, early identification of patients that require antifungal therapy and treatment of sanctuary site infections remain a challenge and will require further innovations.
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Affiliation(s)
- Alex Soriano
- Department of Infectious Diseases, Hospital Clinic of Barcelona, IDIBAPS, CIBERINF, University of Barcelona, Barcelona, Spain
| | - Patrick M Honore
- CHU UCL Godinne Namur, UCL Louvain Medical School, Namur, Belgium
| | - Pedro Puerta-Alcalde
- Department of Infectious Diseases, Hospital Clinic of Barcelona, IDIBAPS, CIBERINF, University of Barcelona, Barcelona, Spain
| | - Carolina Garcia-Vidal
- Department of Infectious Diseases, Hospital Clinic of Barcelona, IDIBAPS, CIBERINF, University of Barcelona, Barcelona, Spain
| | | | | | - Paul E Verweij
- Radboudumc-CWZ Center of Expertise for Mycology, Nijmegen, the Netherlands
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2
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Candura D, Perna A, Calori S, Tamburrelli FC, Proietti L, Meluzio MC, Velluto C, Smakaj A, Santagada DA. Vertebral Candidiasis, the State of the Art: A Systematic Literature Review. ACTA NEUROCHIRURGICA. SUPPLEMENT 2023; 135:231-240. [PMID: 38153475 DOI: 10.1007/978-3-031-36084-8_36] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
OBJECTIVE In recent years, Candida spondylodiscitis has represented an increasingly emerging disease in clinical practice. This condition requires long-term antibiotic therapy and sometimes surgical treatments. The main purpose of this study is to investigate the epidemiology, clinical and radiological aspects, treatment protocols, and outcomes of Candida-mediated vertebral osteomyelitis. METHODS A systematic review of the English literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.The research was conducted on Medline, Cochrane library, PubMed, and Scopus using as search terms "vertebral"; "spinal"; "infection"; "spondylodiscitis"; "discitis"; "osteomyelitis"; "Candida"; and "Candidosis." A case of vertebral candidiasis that was surgically managed was also reported. RESULTS In total, 88 articles were included in our systematic review. Including the reported case, our analysis covered 113 cases of vertebral candidiasis. Candida albicans was isolated in 64 cases (56.1%), Candida tropicalis in 21 (18.4%), Candida glabrata in 14 (12.3%), and Candida parapsilosis in five (4.4%). The mean duration of the follow-up was 395 days. Finally, 87 (82%) patients completely recovered, ten (9.4%) died, and nine (8.5%) reported sequelae. CONCLUSION This systematic review summarized the state of the art on vertebral candidiasis, describing data on its clinical features, diagnostic criteria and current limitations, and treatment alternatives and their outcomes.
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Affiliation(s)
- Dario Candura
- Department of Aging, Neurological, Orthopedic, and Head-Neck Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Andrea Perna
- Department of Aging, Neurological, Orthopedic, and Head-Neck Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Department of Orthopedics and Traumatology, Fondazione Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Rome, Italy
| | - Sara Calori
- Department of Aging, Neurological, Orthopedic, and Head-Neck Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Francesco Ciro Tamburrelli
- Department of Aging, Neurological, Orthopedic, and Head-Neck Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Department of Geriatrics and Orthopedics, Sacred Heart Catholic University, Rome, Italy
| | - Luca Proietti
- Department of Aging, Neurological, Orthopedic, and Head-Neck Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Department of Geriatrics and Orthopedics, Sacred Heart Catholic University, Rome, Italy
| | - Maria Concetta Meluzio
- Department of Aging, Neurological, Orthopedic, and Head-Neck Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Calogero Velluto
- Department of Aging, Neurological, Orthopedic, and Head-Neck Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Amarildo Smakaj
- Department of Aging, Neurological, Orthopedic, and Head-Neck Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Domenico Alessandro Santagada
- Department of Aging, Neurological, Orthopedic, and Head-Neck Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
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Gamaletsou MN, Rammaert B, Brause B, Bueno MA, Dadwal SS, Henry MW, Katragkou A, Kontoyiannis DP, McCarthy MW, Miller AO, Moriyama B, Pana ZD, Petraitiene R, Petraitis V, Roilides E, Sarkis JP, Simitsopoulou M, Sipsas NV, Taj-Aldeen SJ, Zeller V, Lortholary O, Walsh TJ. Osteoarticular Mycoses. Clin Microbiol Rev 2022; 35:e0008619. [PMID: 36448782 PMCID: PMC9769674 DOI: 10.1128/cmr.00086-19] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Osteoarticular mycoses are chronic debilitating infections that require extended courses of antifungal therapy and may warrant expert surgical intervention. As there has been no comprehensive review of these diseases, the International Consortium for Osteoarticular Mycoses prepared a definitive treatise for this important class of infections. Among the etiologies of osteoarticular mycoses are Candida spp., Aspergillus spp., Mucorales, dematiaceous fungi, non-Aspergillus hyaline molds, and endemic mycoses, including those caused by Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides species. This review analyzes the history, epidemiology, pathogenesis, clinical manifestations, diagnostic approaches, inflammatory biomarkers, diagnostic imaging modalities, treatments, and outcomes of osteomyelitis and septic arthritis caused by these organisms. Candida osteomyelitis and Candida arthritis are associated with greater events of hematogenous dissemination than those of most other osteoarticular mycoses. Traumatic inoculation is more commonly associated with osteoarticular mycoses caused by Aspergillus and non-Aspergillus molds. Synovial fluid cultures are highly sensitive in the detection of Candida and Aspergillus arthritis. Relapsed infection, particularly in Candida arthritis, may develop in relation to an inadequate duration of therapy. Overall mortality reflects survival from disseminated infection and underlying host factors.
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Affiliation(s)
- Maria N. Gamaletsou
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Blandine Rammaert
- Université de Poitiers, Faculté de médecine, CHU de Poitiers, INSERM U1070, Poitiers, France
| | - Barry Brause
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Marimelle A. Bueno
- Far Eastern University-Dr. Nicanor Reyes Medical Foundation, Manilla, Philippines
| | | | - Michael W. Henry
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Aspasia Katragkou
- Nationwide Children’s Hospital, Columbus, Ohio, USA
- The Ohio State University School of Medicine, Columbus, Ohio, USA
| | | | - Matthew W. McCarthy
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
| | - Andy O. Miller
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Zoi Dorothea Pana
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Ruta Petraitiene
- Weill Cornell Medicine of Cornell University, New York, New York, USA
| | | | - Emmanuel Roilides
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | | | - Maria Simitsopoulou
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Nikolaos V. Sipsas
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Valérie Zeller
- Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Olivier Lortholary
- Université de Paris, Faculté de Médecine, APHP, Hôpital Necker-Enfants Malades, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, CNRS UMR 2000, Paris, France
| | - Thomas J. Walsh
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
- Center for Innovative Therapeutics and Diagnostics, Richmond, Virginia, USA
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4
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Han JH, Choi S, Yoo JH. Diagnosis and treatment for primary Candida parapsilosis infection of the native knee joint: A case report. Int J Surg Case Rep 2021; 91:106730. [PMID: 35042126 PMCID: PMC8777157 DOI: 10.1016/j.ijscr.2021.106730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction and importance Candida arthritis is a very rare disease and Candida parapsilosis infection of the native knee joint is extremely rare. It is challenging to diagnose and treat because the clinical manifestations, laboratory and radiologic findings are not specific and not well defined. We report the rare case of C. parapsilosis infection of the native knee joint. Case presentation A 67-year-old man visit outpatient clinic for persistent right knee pain and effusion. Inflammatory markers were elevated and the biochemical studies of joint fluid showed elevated WBC counts. Under assumption of septic arthritis, arthroscopic irrigation and debridement were performed. C. parapsilosis was isolated on intraoperative knee joint culture. Fluconazole was used under diagnosis of Candida arthritis. Once there were no relapse of infection, total knee arthroplasty was implemented. Clinical discussion As Candida arthritis can be lead to poor prognosis, Candida arthritis should be considered in patients with untreated knee infections. Blood and radiographic examination, and fungus culture from the knee joint should be accompanied for early diagnosis. Total knee arthroplasty may be considered after treatment of Candida infection with fluconazole. Prognosis was similar compared with patients who underwent total knee arthroplasty for primary knee osteoarthritis. Conclusion If patients complaint persistent knee pain with or without effusion, surgeons should consider the possibility of Candida infection. After diagnosis of Candida arthritis, proper antifungal agents should be used for treatment of infection. After the infection has cleared up, total knee arthroplasty can be planned. Candida infection of the native knee joint is rare but should not be excluded in the presence of knee pain and effusion. Early diagnosis and adequate treatment of Candida arthritis is important. Treatment should be started with fluconazole to address Candida parapsilosis infection. If there is no relapse of infection, total knee arthroplasty can be implemented as a treatment for secondary knee osteoarthritis.
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Affiliation(s)
- Jae Hwi Han
- Department of Orthopedic Surgery, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Sung Choi
- Department of Orthopedic Surgery, Daegu Fatima Hospital, Daegu, Republic of Korea.
| | - Jun Hyug Yoo
- Department of Orthopedic Surgery, Daegu Fatima Hospital, Daegu, Republic of Korea
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5
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De Meo D, Cera G, Ceccarelli G, Castagna V, Aronica R, Pieracci EM, Persiani P, Villani C. Candida fracture-related infection: a systematic review. J Bone Jt Infect 2021; 6:321-328. [PMID: 34458074 PMCID: PMC8386193 DOI: 10.5194/jbji-6-321-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 07/28/2021] [Indexed: 11/11/2022] Open
Abstract
Background: The aim of this study is to summarize and improve knowledge regarding a Candida fracture-related infection (CFRI) through a systematic review on the topic, accompanied by a case report. Methods: A systematic review and meta-analysis based on PRISMA statement were conducted on the CFRI topic. The following combined search terms were used to explore PubMed, Cochrane, and the Embase database: "fungal infection", "candida", "fracture related infection", "bone infection", "orthopedic infection", "internal fixation", "post-traumatic infection", and "osteomyelitis". Results: Out of 1514 records, only 5 case reports matched the selection criteria and were included. Moreover, a new case of CFRI, not previously described, was reported in this paper and reviewed. The main risk factors for CFRI were open wounds (three cases) and immunodeficiency (three cases). Initial improvement of clinical and laboratory signs of infection was noted in all cases. In the available short-term follow-up (mean 12.1 months; range 3-42), the reoperation rate was 33.3 %. Using a strategy based on extensive debridement/resection methods and prolonged systemic antifungal therapy (mean 8.8 weeks; range 6-18), four of six cases (66.6 %) were cured. Bone union occurred in three out of six cases. Conclusion: There is very low-quality evidence available regarding CFRI. Candida infections in surgically treated fractures are rare but difficult-to-treat events, with a slow onset, unspecific symptoms or signs, and a significant relapse risk; therefore, they still represent a current diagnostic challenge. The existing fracture-related infection treatment algorithm combined with long-term systemic antifungal therapy has an anecdotal value and needs more extensive studies to be validated.
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Affiliation(s)
- Daniele De Meo
- Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, Sapienza University of Rome, Piazzale A. Moro 5, 00155, Rome, Italy.,M.I.T.O. Study Group (Infectious Diseases in Traumatology and Orthopedics Surgery), Policlinico Umberto I University Hospital, Viale del Policlinico, 155,00161 Rome, Italy
| | - Gianluca Cera
- Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, Sapienza University of Rome, Piazzale A. Moro 5, 00155, Rome, Italy
| | - Giancarlo Ceccarelli
- M.I.T.O. Study Group (Infectious Diseases in Traumatology and Orthopedics Surgery), Policlinico Umberto I University Hospital, Viale del Policlinico, 155,00161 Rome, Italy.,Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale A. Moro 5, 00155, Rome, Italy
| | - Valerio Castagna
- Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, Sapienza University of Rome, Piazzale A. Moro 5, 00155, Rome, Italy
| | - Raissa Aronica
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale A. Moro 5, 00155, Rome, Italy
| | - Edoardo M Pieracci
- Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, Sapienza University of Rome, Piazzale A. Moro 5, 00155, Rome, Italy
| | - Pietro Persiani
- Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, Sapienza University of Rome, Piazzale A. Moro 5, 00155, Rome, Italy
| | - Ciro Villani
- Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, Sapienza University of Rome, Piazzale A. Moro 5, 00155, Rome, Italy.,M.I.T.O. Study Group (Infectious Diseases in Traumatology and Orthopedics Surgery), Policlinico Umberto I University Hospital, Viale del Policlinico, 155,00161 Rome, Italy
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6
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Levy A, Harran N, Hammer M, Bennaim M. Fungal osteomyelitis caused by
Candida glabrata
in a Groenendael dog. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Alice Levy
- Department of Diagnostic ImagingAquivet Centre Hospitalier VétérinaireEysinesNouvelle‐AquitaineFrance
| | - Nathaniel Harran
- Department of Diagnostic ImagingAquivet Centre Hospitalier VétérinaireEysinesNouvelle‐AquitaineFrance
| | - Meike Hammer
- Department of SurgeryAquivet Centre Hospitalier VétérinaireEysinesNouvelle‐AquitaineFrance
| | - Michael Bennaim
- Department of Internal MedicineAquivet Centre Hospitalier VétérinaireEysinesNouvelle‐AquitaineFrance
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7
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Papachristou SG, Iosifidis E, Sipsas NV, Gamaletsou MN, Walsh TJ, Roilides E. Management of osteoarticular fungal infections in the setting of immunodeficiency. Expert Rev Anti Infect Ther 2020; 18:461-474. [PMID: 32213145 DOI: 10.1080/14787210.2020.1748499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: Osteoarticular fungal infections (OAFIs) complicate the clinical course of high-risk patients, including immunosuppressed individuals. Their management, however, despite being intricate, is governed by evidence arising from sub-optimal quality research, such as case series. Guidelines are scarce and when present result in recommendations based on low quality evidence. Furthermore, the differences between the management of immunocompromised and immunocompetent patients are not distinct. This is a narrative review after a literature search in PubMed, up to November 2019.Areas covered: The major fungal groups causing osteomyelitis and/or arthritis are Candida spp., Aspergillus spp., non-Aspergillus filamentous fungi, non-Candida yeasts and endemic dimorphic fungi. Their epidemiology is briefly analyzed with emphasis on immunodeficiency and other risk factors. Management of OAFIs includes appropriate antifungal drug therapy (liposomal amphotericin B, triazoles or echinocandins), local surgery and immunotherapy for primary immunodeficiencies. Cessation of immunosuppressive drugs is also mandated.Expert opinion: Management of OAFIs includes affordable and available options and approaches. However, research on therapeutic practices is urgently required to be further improved, due to the rarity of affected patients. Evolution is expected to translate into novel antifungal drugs, less invasive and precise surgical approaches and targeted enhancement of immunoregulatory pathways in defense of challenging fungal pathogens.
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Affiliation(s)
- Savvas G Papachristou
- Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences and Hippokration General Hospital, Thessaloniki, Greece
| | - Elias Iosifidis
- Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences and Hippokration General Hospital, Thessaloniki, Greece
| | - Nikolaos V Sipsas
- Infectious Diseases Unit, Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria N Gamaletsou
- Infectious Diseases Unit, Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Thomas J Walsh
- Departments of Medicine, Pediatrics, and Microbiology & Immunology, Weill Cornell Medicine of Cornell University and New York Presbyterian Hospital, New York, NY, USA
| | - Emmanuel Roilides
- Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences and Hippokration General Hospital, Thessaloniki, Greece
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8
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Daya Attie M, Anderson IA, Portnof J. Mandibular Osteomyelitis Associated with Candida Albicans in Marijuana and Heroin Abusers. Ann Maxillofac Surg 2018; 8:355-357. [PMID: 30693264 PMCID: PMC6327820 DOI: 10.4103/ams.ams_83_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Osteomyelitis of the mandible is most commonly caused by bacterial infections and is rarely linked to fungal infections. In 2003, Friedman et al. studied the relationship of multiple drugs including marijuana, opioids, nicotine, and alcohol and its effect on the immune system. It is important to consider potential risks and complications of patients who are immunocompromised and present a history of substance abuse. These complications include infections and osteomyelitis which can be associated with multiple microorganisms; some of the most common microorganisms isolated in mandibular osteomyelitis include Streptococcus, Eikenella, and Candida. Candida albicans is commonly found in the skin and mucosa of healthy individuals; however, it has been proven to cause disease in individuals who are immunocompromised. Two cases of mandibular osteomyelitis after routine dental extractions and a history of drug abuse, including heroin and marijuana, are presented in this case series. These specific infections were resistant to multiple antibiotic therapy and grew C. albicans species in cultures collected. These cases were treated with irrigation and debridement or mandibular resection in combination with antimicrobial treatment and fluconazole with complete resolution. Although osteomyelitis is most commonly caused by bacterial infections, special attention must be given to patients with medical histories of immunosuppression and intravenous drug use. Patients who do not respond to broad-spectrum antibiotics might benefit from bacterial and fungal cultures and sensitivity. Antifungal treatment with an antifungal agent, such as oral fluconazole, is indicated if fungal organisms are yielded in the culture.
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Affiliation(s)
- Mikhail Daya Attie
- Broward Health Medical Center, Nova Southeastern University, Fort Lauderdale, FL, USA
| | | | - Jason Portnof
- Department of Oral and Maxillofacial Surgery, Joe DiMaggio Children's Hospital, Nova Southeastern University, Fort Lauderdale, FL, USA
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9
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Waldon K, Chattopadhyay T. Lessons learned from a case of Candida Discitis. Age Ageing 2018; 47:156. [PMID: 28985261 DOI: 10.1093/ageing/afx152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 08/05/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Karen Waldon
- Salford Royal NHS Foundation Trust, Manchester, UK
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10
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Rodrigues CF, Gonçalves B, Rodrigues ME, Silva S, Azeredo J, Henriques M. The Effectiveness of Voriconazole in Therapy of Candida glabrata's Biofilms Oral Infections and Its Influence on the Matrix Composition and Gene Expression. Mycopathologia 2017; 182:653-664. [PMID: 28439794 DOI: 10.1007/s11046-017-0135-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 04/16/2017] [Indexed: 11/25/2022]
Abstract
Candida glabrata is one of most prevalent yeast in fungal infections, especially in immunocompromised patients. Its azole resistance results in a low therapeutic response, particularly when associated with biofilms. The main goal of this work was to study the effectiveness of voriconazole (Vcz) against C. glabrata biofilms oral pathologies, as esophageal or oropharyngeal candidiasis. Antifungal susceptibilities were determined in pre-formed 24-h-biofilms and ERG genes expression was determined by qRT-PCR. Protein quantification was performed using BCA® Kit, carbohydrate was estimated according to the Dubois assay and β-1,3 glucans concentration were determined using Glucatell® kit. Finally, ergosterol, Vcz, and fluconazole (Flu) concentrations within the biofilm matrices were determined by RP-HPLC. Results showed that C. glabrata biofilms were more susceptible to Vcz than to Flu and that ERG genes expression evidenced an overexpression of the three ERG genes in the presence of both azoles. The matrix content presented a remarked decrease in proteins and an increase in carbohydrates, namely β-1,3 glucans. Ergosterol was successfully detected and quantified in the biofilm matrices, with no differences in all the considered conditions. Vcz demonstrated better diffusion through the biofilms and better cell penetration capacities, than Flu, indicating that the structure of the drug molecule fully influences its dissemination through the biofilm matrices. This work showed that Vcz is notably more effective than Flu for the treatment of resistant C. glabrata oral biofilms, which demonstrates a clinical relevance in its future use for the treatment of oropharyngeal/esophageal candidiasis caused by this species.
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Affiliation(s)
- Célia F Rodrigues
- CEB, Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057, Braga, Portugal.
| | - Bruna Gonçalves
- CEB, Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057, Braga, Portugal
| | - Maria Elisa Rodrigues
- CEB, Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057, Braga, Portugal
| | - Sónia Silva
- CEB, Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057, Braga, Portugal
| | - Joana Azeredo
- CEB, Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057, Braga, Portugal
| | - Mariana Henriques
- CEB, Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057, Braga, Portugal
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11
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Ma L, Tong H, Ruan L, Ling Z, Ren Y, Zhou X. Successful treatment of Candida tropicalis osteomyelitis with Micafungin in a leukemia patient. IDCases 2016; 6:109-111. [PMID: 27942462 PMCID: PMC5142103 DOI: 10.1016/j.idcr.2016.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 10/03/2016] [Accepted: 10/03/2016] [Indexed: 11/08/2022] Open
Affiliation(s)
- Liya Ma
- Hematology Department, the First Affiliated Hospital of Zhejiang University, China
| | - Hongyan Tong
- Hematology Department, the First Affiliated Hospital of Zhejiang University, China
| | - Lingxiang Ruan
- Radiology Department, the First Affiliated Hospital of Zhejiang University, China
| | - Zhiheng Ling
- Orthopedics Department, the First Affiliated Hospital of Zhejiang University, China
| | - Yanling Ren
- Hematology Department, the First Affiliated Hospital of Zhejiang University, China
| | - Xinping Zhou
- Hematology Department, the First Affiliated Hospital of Zhejiang University, China
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12
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Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, Reboli AC, Schuster MG, Vazquez JA, Walsh TJ, Zaoutis TE, Sobel JD. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis 2016; 62:e1-50. [PMID: 26679628 PMCID: PMC4725385 DOI: 10.1093/cid/civ933] [Citation(s) in RCA: 1797] [Impact Index Per Article: 224.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 11/02/2015] [Indexed: 02/06/2023] Open
Abstract
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.
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Affiliation(s)
| | - Carol A Kauffman
- Veterans Affairs Ann Arbor Healthcare System and University of Michigan Medical School, Ann Arbor
| | | | | | - Kieren A Marr
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | | | | | | | - Thomas J Walsh
- Weill Cornell Medical Center and Cornell University, New York, New York
| | | | - Jack D Sobel
- Harper University Hospital and Wayne State University, Detroit, Michigan
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13
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Chen SC, Sorrell TC, Chang CC, Paige EK, Bryant PA, Slavin MA. Consensus guidelines for the treatment of yeast infections in the haematology, oncology and intensive care setting, 2014. Intern Med J 2015; 44:1315-32. [PMID: 25482743 DOI: 10.1111/imj.12597] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Pathogenic yeast forms are commonly associated with invasive fungal disease in the immunocompromised host, including patients with haematological malignancies and patients of haemopoietic stem cell transplants. Yeasts include the Candida spp., Cryptococcus spp., Pneumocystis jirovecii and some lesser-known pathogens. Candida species remain the most common cause of invasive yeast infections (and the most common human pathogenic fungi). These guidelines present evidence-based recommendations for the antifungal management of established, invasive yeast infections in adult and paediatric patients in the haematology/oncology setting. Consideration is also given to the critically ill patient in intensive care units, including the neonatal intensive care unit. Evidence for 'pre-emptive' or 'diagnostic-driven antifungal therapy' is also discussed. For the purposes of this paper, invasive yeast diseases are categorised under the headings of invasive candidiasis, cryptococcosis and uncommon yeast infections. Specific recommendations for the management of Pneumocystis jirovecii are presented in an accompanying article (see consensus guidelines by Cooley et al. appearing elsewhere in this supplement).
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Affiliation(s)
- S C Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR - Pathology West, Westmead, New South Wales; Department of Infectious Diseases, Westmead Hospital, Westmead, New South Wales; Sydney Medical School, The University of Sydney, Sydney, New South Wales
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14
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Salzer HJF, Rolling T, Klupp EM, Schmiedel S. Hematogenous dissemination of Candida dubliniensis causing spondylodiscitis and spinal abscess in a HIV-1 and HCV-coinfected patient. Med Mycol Case Rep 2015; 8:17-20. [PMID: 25750857 PMCID: PMC4348452 DOI: 10.1016/j.mmcr.2015.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 01/31/2015] [Accepted: 02/23/2015] [Indexed: 12/15/2022] Open
Abstract
We report a case of spondylodiscitis and spinal abscess following haematogenous dissemination of the emerging yeast Candida dubliniensis in a human immunodeficiency virus-1 (HIV-1) and hepatitis C virus (HCV)-coinfected patient. Although C. dubliniensis is considered less virulent compared to its closest known relative Candida albicans, reports of severe fungal infections are increasing. This case indicates that the pathogenicity of C. dubliniensis may be higher than previously believed. Therefore fungal infections caused by this dimorph fungus should be kept in mind in immunocompromised patients with spondylodiscitis and spinal abscess.
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Affiliation(s)
- Helmut J F Salzer
- Department of Internal Medicine I, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Thierry Rolling
- Department of Internal Medicine I, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Eva-Maria Klupp
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Schmiedel
- Department of Internal Medicine I, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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15
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Lopez R, Hunter AR, Geoghegan O, Demertzi E. Candida parapsilosis osteomyelitis. BMJ Case Rep 2014; 2014:bcr-2014-206520. [PMID: 25320262 DOI: 10.1136/bcr-2014-206520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 51-year-old previously fit and healthy gentleman sustained a circular saw injury to his right thumb with partial amputation and an open multifragmentary fracture of his distal phalanx. He underwent open reduction and internal fixation under the hand surgery team. He developed a postoperative infection discharging pus 2 weeks postoperatively, which later grew Candida parapsilosis. He underwent radical debridement and removal of a K-wire, then a further second debridement 2 days later. Ceftriaxone was started empirically while awaiting cultures. Tissue and bone biopsy samples obtained in theatre all grew C. parapsilosis and he was started on caspofungin for 1 week, and switched on to oral fluconazole to complete a 6-week course. He has progressed well and has regained function in his thumb after 3 months, without any sign of ongoing infection.
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Affiliation(s)
- Rekha Lopez
- Department of Microbiology, Imperial College NHS Healthcare Trust, London, UK
| | | | - Orla Geoghegan
- Department of Pharmacy, Chelsea and Westminster, London, UK
| | - Elli Demertzi
- Department of Microbiology, Imperial College NHS Healthcare Trust, London, UK
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16
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Cervical Bone Graft Candida albicans Osteomyelitis: Management Strategies for an Uncommon Infection. Case Rep Orthop 2014; 2014:986393. [PMID: 25295206 PMCID: PMC4176649 DOI: 10.1155/2014/986393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 09/01/2014] [Indexed: 11/17/2022] Open
Abstract
Candida osteomyelitis in the current literature is an emerging infection. The factors contributing to its emergence include a growing population of immunosuppressed patients, invasive surgeries, broad-spectrum antibiotics, injection drug users, and alcohol abuse. The diagnosis requires a high degree of suspicion. The insidious progression of infection and the nonspecificity of laboratory and radiologic findings may contribute to a delay in diagnosis. The current case concerns a 27-year-old man with a spinal cord injury who, after undergoing anterior cervical fixation and fusion surgery, developed postoperative systemic bacterial infection and required long-term antibiotic therapy. After six months, a CT scan demonstrated an almost complete anterior dislocation of the implants caused by massive bone destruction and reabsorption in Candida albicans infection. The patient underwent a second intervention consisting firstly of a posterior approach with C4-C7 fixation and fusion, followed by a second anterior approach with a corpectomy of C5 and C6, a tricortical bone grafting from the iliac crest, and C4-C7 plating. The antifungal therapy with fluconazole was effective without surgical debridement of the bone graft, despite the fact that signs of the bone graft being infected were seen from the first cervical CT scans carried out after one month.
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17
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Storm L, Lausch KR, Arendrup MC, Mortensen KL, Petersen E. Vertebral infection with Candida albicans failing caspofungin and fluconazole combination therapy but successfully treated with high dose liposomal amphotericin B and flucytosine. Med Mycol Case Rep 2014; 6:6-9. [PMID: 25379389 PMCID: PMC4216330 DOI: 10.1016/j.mmcr.2014.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 06/16/2014] [Accepted: 07/01/2014] [Indexed: 11/01/2022] Open
Abstract
A patient with Candida spondylitis failed two weeks of fluconazole combined with caspofungin, and the infection relapsed despite six weeks of liposomal amphotericin B followed by two months of fluconazole. Six months therapy with high dose liposomal amphotericin B combined with flucytosine effectively cured the patient.
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Affiliation(s)
- Line Storm
- Department of Infectious Diseases, Aarhus University Hospital Skejby, 100 Brendstrupgaardsvej, 8200 Aarhus N, Denmark
| | - Karen R Lausch
- Department of Infectious Diseases, Aarhus University Hospital Skejby, 100 Brendstrupgaardsvej, 8200 Aarhus N, Denmark
| | - Maiken C Arendrup
- Unit of Mycology, Department of Microbiology and Infection Control, Statens Serum Institut, 5 Artillerivej, 2300 Copenhagen S, Denmark
| | - Klaus L Mortensen
- Department of Infectious Diseases, Aarhus University Hospital Skejby, 100 Brendstrupgaardsvej, 8200 Aarhus N, Denmark
| | - Eskild Petersen
- Department of Infectious Diseases, Aarhus University Hospital Skejby, 100 Brendstrupgaardsvej, 8200 Aarhus N, Denmark
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