Osteomyelitis of the spine in a burn patient due to Candida albicans.
A 38-year-old white-skinned male was burned in an ultralight plane crash and sustained a 59 per cent body surface area burn, mostly full thickness skin loss. A fracture of the first lumbar vertebra was noted at admission which was treated without surgery. Candida septicaemia was diagnosed and treated during the acute phase of injury. Extensive grafting was required. Following discharge, the patient began experiencing low-grade back pain which was aggravated on postburn day 277 by a fall down a flight of stairs. Spinal radiographs obtained following this fall revealed osteomyelitis at the level of the eighth and ninth vertebrae with an intervertebral abscess. Following evacuation of the disc space during surgery, the organism was identified as Candida albicans. Treatment with amphotericin B and later fluconazole was initiated. Recovery was uneventful. The infection, probably of a haematogenous origin, is the first such case reported in the literature to our knowledge.
Mullins
R F
RF
Humana Hospital Center, Augusta, Georgia.
Still
J M
JM
Savage
J
J
Davis
J B
JB
Law
E J
EJ
D000060:Accidents, Aviation; D000328:Adult; D002056:Burns / Q000150:complications* / Q000382:microbiology; D002177:Candidiasis / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology*; D013122:Spinal Diseases / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology*; D016103:Spinal Fractures / Q000150:complications* / Q000382:microbiology