heroin and Discitis

Topics: Cervical Vertebrae; Discitis; Epidural Abscess; Heroin; Humans; Injections, Intravenous; Jugular Veins; Lemierre Syndrome; Male; Middle Aged; Substance Abuse, Intravenous; Tomography, X-Ray Computed

Spondylodiscitis leads to debility, and few data exist on Candida spondylodiscitis in patients with intravenous drug use.. We present a case of Candida albicans lumbar spondylodiscitis in a patient with intravenous drug use. This patient was treated with surgical debridement and 9 months of fluconazole therapy, and the neurological deficits resolved completely. The infection did not recur clinically or radiologically during 9 months of follow-up.. Although Candida albicans lumbar spondylodiscitis is rare, Candida should be suspected as a causative pathogen in patients with intravenous drug use except for Staphylococcus aureus, Pseudomonas aeruginosa, and Mycobacterium tuberculosis. As soon as Candida albicans lumbar spondylodiscitis is suspected, magnetic resonance imaging and percutaneous biopsy should be performed. Surgical intervention combined with treatment with antifungal medications can successfully eradicate the infection and resolve the neurological deficits.

Topics: Adult; Candida albicans; Candidiasis; Discitis; Heroin; Humans; Injections, Intravenous; Lumbosacral Region; Male; Substance-Related Disorders

We describe 3 patients with a history of intravenous (iv) heroin addiction presenting with indolent, persisting lumbar pain. Clinical findings and initial investigations were unremarkable. Gallium scintigraphy revealed septic spondylodiscitis, and cultures of material obtained by biopsy were positive for Candida albicans in all 3 cases. Two patients were treated with iv amphotericin B and the other with fluconazole with excellent results. Surgical treatment was needed only in one patient because of neurological involvement.

Topics: Adult; Candidiasis; Discitis; Female; Heroin; Humans; Lumbar Vertebrae; Male; Middle Aged; Osteomyelitis; Radiography; Substance Abuse, Intravenous; Thoracic Vertebrae

Topics: Adult; Analgesia; Candidiasis; Discitis; Heroin; HIV Seropositivity; Humans; Injections, Spinal; Male; Substance-Related Disorders