Candida albicans spinal epidural abscess secondary to prosthetic valve endocarditis.
A 56-year-old woman, with underlying rheumatic heart disease status post mitral valve replacement, presented with fever, low back pain radiating to right leg, and congestive heart failure. Magnetic resonance imaging detected an L5-S1 spinal epidural abscess. A vegetation on prosthetic mitral valve was found by transesophageal echocardiography. Cultures of epidural aspirate, surgical specimen, and blood all grew Candida albicans. She received surgical drainage of the spinal epidural abscess and i.v. amphotericin B 1 mg/kg/day for eight weeks. Clinical symptoms improved gradually and she was discharged without neurologic sequelae. She remained well and continued to lead an active life two years after discharge.
Liang
J D
JD
Department of Internal Medicine and Laboratory Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, 100, Taipei, Taiwan.
Fang
C T
CT
Chen
Y C
YC
Chang
S C
SC
Luh
K T
KT
D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D002176:Candida albicans / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology* / Q000503:physiopathology / Q000601:surgery; D004696:Endocarditis / Q000188:drug therapy / Q000382:microbiology* / Q000503:physiopathology / Q000601:surgery; D020802:Epidural Abscess / Q000188:drug therapy / Q000382:microbiology* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000382:microbiology*; D006801:Humans; D008159:Lumbar Vertebrae / Q000382:microbiology*; D008875:Middle Aged; D013168:Spondylolisthesis / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome
D000666:Amphotericin B; D015725:Fluconazole