Candida tropicalis vertebral osteomyelitis complicating epidural catheterisation with disease paralleled by elevated D-arabinitol/L-arabinitol ratios.
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.
Eisen
D P
DP
Infectious Diseases Unit, Royal Brisbane Hospital, Herston, Queensland, Australia. eisend@health.qld.gov.au
MacGinley
R
R
Christensson
B
B
Larsson
L
L
Woods
M L
ML
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*
D013402:Sugar Alcohols; C014999:arabitol