title: Candida tropicalis vertebral osteomyelitis complicating epidural catheterisation with disease paralleled by elevated D-arabinitol/L-arabinitol ratios.
abstract: Deep-seated Candida infections are challenging to diagnose by noninvasive means, and new modalities are needed to improve the yield of such investigations. Reported here is a case of Candida tropicalis vertebral osteomyelitis complicating epidural catheterisation in a diabetic patient with complicated abdominal sepsis. The diagnosis was supported by detection of increased D-arabinitol/L-arabinitol ratios in urine samples, and failure of medical management was indicated by elevated D-arabinitol/L-arabinitol ratios, which later decreased to baseline with successful surgical debridement and prolonged antifungal therapy.
authors.affiliation: Infectious Diseases Unit, Royal Brisbane Hospital, Herston, Queensland, Australia. eisend@health.qld.gov.au
authors.forename: D P
authors.initials: DP
authors.lastname: Eisen
authors.forename: R
authors.initials: R
authors.lastname: MacGinley
authors.forename: B
authors.initials: B
authors.lastname: Christensson
authors.forename: L
authors.initials: L
authors.lastname: Larsson
authors.forename: M L
authors.initials: ML
authors.lastname: Woods
mesh_terms: D000368:Aged; D015360:Analgesia, Epidural; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis* / Q000382:microbiology / Q000652:urine; D002404:Catheterization / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis* / Q000382:microbiology / Q000652:urine; D013131:Spine / Q000473:pathology; D013402:Sugar Alcohols / Q000652:urine*
chemical_list: D013402:Sugar Alcohols; C014999:arabitol