{"id":"0f07beab-9f54-49a1-b8dd-6f145d9476b6","slug":"cervical-spondylodiscitis-caused-by-candida-albicans-in-a-non-immunocompromised-patient-a-case-report-and-review-of-literature","title":"Cervical spondylodiscitis caused by <i>Candida albicans</i> in a non-immunocompromised patient: A case report and review of literature","authors":["Shiwei Huang","Ari D. Kappel","Catherine Peterson","Parthasarathi Chamiraju","Gary B. Rajah","Marc D. Moisi"],"abstract":"Background: Fungal cervical spondylodiscitis is rare and accounts for less than 1% of all cervical, thoracic, and lumbar vertebral osteomyelitis and discitis. Case Description: A 32-year-old non-immunocompromised male presented with persistent neck pain and paresthesias. The magnetic resonance imaging of the cervical spine demonstrated a contrast-enhancing erosive lesion involving the cervical C6 and C7 vertebral bodies accompanied by epidural phlegmon. Blood culture was negative. The patient underwent a C6 and C7 anterior corpectomy with instrumented fusion (e.g., expandable cage C5 to T1). Intraoperatively, frank pus was noted within the C6-C7 disc space and was accompanied by thick prevertebral and epidural phlegmon extending from C5 to T1. Intraoperative cultures grew Candida albicans. Three days later, a C6-C7 laminectomy with C4-T2 posterior instrumented fusion was performed; the cultures again grew C. albicans. The patient was treated with intravenous micafungin for 14 days followed by 6–12 months of 400 mg oral fluconazole daily. Conclusion: There are few cases in literature where non-immunocompromised patients developed fungal cervical spondylodiscitis. Prompt diagnosis and appropriate management are critical to effectively treat these patients. Surgical intervention may warrant corpectomy, discectomy, and operative debridement followed by long-term targeted antifungal therapy.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/0f07beab-9f54-49a1-b8dd-6f145d9476b6/featured/hero-1781563813649.png","publishDate":"2019-08-02T00:00:00.000Z","doi":"10.25259/SNI_240_2019","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/0f07beab-9f54-49a1-b8dd-6f145d9476b6/pdf"}