title: Candida parapsilosis osteomyelitis.
abstract: A 51-year-old previously fit and healthy gentleman sustained a circular saw injury to his right thumb with partial amputation and an open multifragmentary fracture of his distal phalanx. He underwent open reduction and internal fixation under the hand surgery team. He developed a postoperative infection discharging pus 2 weeks postoperatively, which later grew Candida parapsilosis. He underwent radical debridement and removal of a K-wire, then a further second debridement 2 days later. Ceftriaxone was started empirically while awaiting cultures. Tissue and bone biopsy samples obtained in theatre all grew C. parapsilosis and he was started on caspofungin for 1 week, and switched on to oral fluconazole to complete a 6-week course. He has progressed well and has regained function in his thumb after 3 months, without any sign of ongoing infection.
authors.affiliation: Department of Microbiology, Imperial College NHS Healthcare Trust, London, UK.
authors.forename: Rekha
authors.initials: R
authors.lastname: Lopez
authors.affiliation: Trauma and Orthopaedics, Chelsea and Westminster, London, UK.
authors.forename: Alistair Robert
authors.initials: AR
authors.lastname: Hunter
authors.affiliation: Department of Pharmacy, Chelsea and Westminster, London, UK.
authors.forename: Orla
authors.initials: O
authors.lastname: Geoghegan
authors.affiliation: Department of Microbiology, Imperial College NHS Healthcare Trust, London, UK.
authors.forename: Elli
authors.initials: E
authors.lastname: Demertzi
mesh_terms: D000673:Amputation, Traumatic / Q000601:surgery; D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida; D002177:Candidiasis / Q000175:diagnosis* / Q000188:drug therapy; D002443:Ceftriaxone / Q000627:therapeutic use; D003646:Debridement; D004359:Drug Therapy, Combination; D050278:Finger Phalanges / Q000293:injuries* / Q000601:surgery; D015725:Fluconazole / Q000627:therapeutic use; D005593:Fracture Fixation, Internal; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013933:Thumb / Q000293:injuries* / Q000601:surgery
chemical_list: D000935:Antifungal Agents; D002443:Ceftriaxone; D015725:Fluconazole