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Open Access 04-10-2023 | Spondylodiscitis | Review

Candida spondylodiscitis: a systematic review and meta-analysis of seventy two studies

Authors: Siegfried J. Adelhoefer, Marcos R. Gonzalez, Angad Bedi, Arne Kienzle, Henrik C. Bäcker, Octavian Andronic, Daniel Karczewski

Published in: International Orthopaedics | Issue 1/2024

Abstract

Objectives

Knowledge of Candida spondylodiscitis is limited to case reports and smaller case series. Controversy remains on the most effective diagnostical and therapeutical steps once Candida is suspected. This systematic review summarized all cases of Candida spondylodiscitis reported to date concerning baseline demographics, symptoms, treatment, and prognostic factors.

Methods

A PRISMA-based search of PubMed, Web of Science, Embase, Scopus, and OVID Medline was performed from database inception to November 30, 2022. Reported cases of Candida spondylodiscitis were included regardless of Candida strain or spinal levels involved. Based on these criteria, 656 studies were analyzed and 72 included for analysis. Kaplan-Meier curves, Fisher’s exact, and Wilcoxon’s rank sum tests were performed.

Results

In total, 89 patients (67% males) treated for Candida spondylodiscitis were included. Median age was 61 years, 23% were immunocompromised, and 15% IV drug users. Median length of antifungal treatment was six months, and fluconazole (68%) most commonly used. Thirteen percent underwent debridement, 34% discectomy with and 21% without additional instrumentation. Median follow-up was 12 months. The two year survivorship free of death was 80%. The two year survivorship free of revision was 94%. Younger age (p = 0.042) and longer length of antifungal treatment (p = 0.061) were predictive of survival.

Conclusion

Most patients affected by Candida spondylodiscitis were males in their sixties, with one in four being immunocompromised. While one in five patients died within two years of diagnosis, younger age and prolonged antifungal treatment might play a protective role.

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Title: Candida spondylodiscitis: a systematic review and meta-analysis of seventy two studies
Authors: Siegfried J. Adelhoefer
Marcos R. Gonzalez
Angad Bedi
Arne Kienzle
Henrik C. Bäcker
Octavian Andronic
Daniel Karczewski
Publication date: 04-10-2023
Publisher: Springer Berlin Heidelberg
Keywords: Spondylodiscitis
Fluconazole
Wound Debridement
Amphotericin B
Candida Albicans
Candida Balanitis
Published in: International Orthopaedics / Issue 1/2024
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-023-05989-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Candida spondylodiscitis: a systematic review and meta-analysis of seventy two studies

Abstract

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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