title: Candida albicans osteomyelitis as a cause of chest pain and visual loss.
abstract: Candida albicans osteomyelitis is a rare disease that occurs in immunocompromised individuals, sometimes with a late diagnosis related to the mismatch between symptoms and candidemia. This case refers to a 36-year-old male patient with a history of oesophageal surgery for achalasia with multiple subsequent surgeries and hospitalisation in the intensive care unit for oesophageal fistula complication. Four months after discharge, the patient was admitted to the infectious diseases department with pain in the 10th-12th left ribs, swelling of the 4th-6th costal cartilage and decreased visual acuity. An MRI study showed thickening and diffuse enhancement, with no defined borders in the cartilage and ribs, compatible with infection. After performing a CT-guided bone biopsy, isolated C. albicans sensitive to antifungal agents was detected. The patient started therapy with liposomal amphotericin B and maintenance fluconazole for 6 months and showed clinical and radiological improvement within this time.
authors.affiliation: Department of Infectious Disease, Coimbra's Hospital Centre and University, Coimbra, Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Magano
authors.affiliation: Department of Infectious Disease, Coimbra's Hospital Centre and University, Coimbra, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Cortez
authors.affiliation: Clinica Vida Cligeste, Luanda, Angola.
authors.forename: Evelise
authors.initials: E
authors.lastname: Ramos
authors.affiliation: Department of Infectious Disease, Coimbra's Hospital Centre and University, Coimbra, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Trindade
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001766:Blindness / Q000382:microbiology*; D002176:Candida albicans; D002177:Candidiasis / Q000150:complications* / Q000382:microbiology; D002637:Chest Pain / Q000382:microbiology*; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000150:complications / Q000382:microbiology*; D012272:Ribs / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B; D015725:Fluconazole