title: Diagnosis and treatment of Candida vertebral osteomyelitis: clinical experience with a short course therapy of amphotericin B lipid complex.
abstract: BACKGROUND
  Musculoskeletal candidiasis occurs in some patients with candidemia resulting from organ infection, IV drug use, or indwelling central venous catheters. Diagnosis is often difficult because of vague symptomatology and a frequent afebrile course.
  
  
  METHODS
  Three patients with Candida vertebral osteomyelitis are presented. All followed the use of indwelling central venous access catheters and antimicrobial therapy between 6 months and 3 years earlier. In 2, fungemia with the same Candida spp. preceded the spondylodiskitis. These 3 patients bring to nearly 75 the number of reported individuals with what was once quite rare. Although IV amphotericin B doxycholate and fluconazole have usually been effective therapy over prolonged periods of time, we used liposomal amphotericin B to treat 2 of our 3 patients. Both received 5 mg/kg daily for 18-42 days that resulted in total disappearance of signs and symptoms.
  
  
  CONCLUSIONS
  This relatively brief duration of therapy reduces treatment time and is cost-effective.
authors.affiliation: Departments of Medicine, Section of Infectious Diseases and Pathology, Section of Medical Microbiology, Eisenhower Medical Center, Rancho Mirage, California, USA.
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Cone
authors.forename: Richard G
authors.initials: RG
authors.lastname: Byrd
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Potts
authors.forename: Moxell
authors.initials: M
authors.lastname: Wuesthoff
mesh_terms: D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy*; D015299:Discitis / Q000175:diagnosis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004338:Drug Combinations; D006801:Humans; D008159:Lumbar Vertebrae / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000188:drug therapy*; D010713:Phosphatidylcholines / Q000008:administration & dosage / Q000627:therapeutic use*; D010715:Phosphatidylglycerols / Q000008:administration & dosage / Q000627:therapeutic use*; D013904:Thoracic Vertebrae / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D004338:Drug Combinations; D010713:Phosphatidylcholines; D010715:Phosphatidylglycerols; C068538:liposomal amphotericin B; D000666:Amphotericin B