We report the cases of two patients with
spondylodiskitis due to Candida albicans who were successfully treated with
fluconazole. On the basis of findings from these cases and a review of 52 mycologically proven cases in the literature, we describe the main characteristics of candidal
spondylodiskitis. In 60% of the cases, candidal
spondylodiskitis was a late complication of
candidemia (mean delay, 5.2 months) it was determined to be a complication on the basis of the results of previously positive blood cultures (19 cases), and it was presumed to be a complication in iv drug addicts (12 cases). As
spondylodiskitis can be a late complication of
candidemia, all episodes of
candidemia should be treated with systemic
antifungal agents. Clinical and radiological signs of candidal
spondylodiskitis were nonspecific. Any bone or joint symptoms in a patient who has had
candidemia should be considered to be of fungal origin at the time of presentation. The definitive diagnosis of candidal
spondylodiskitis was made on the basis of the results of percutaneous
puncture in 26 of 30 cases. The overall prognosis for patients with candidal
spondylodiskitis was good, with the full recovery rate ranging from 67% to 100%. The preliminary results of treating candidal
spondylodiskitis with
triazole derivatives, particularly
fluconazole, were satisfactory; there was excellent tolerance of this
drug.