Candida auris osteomielitis: Case report

Abstract

Introduction: Candida auris is an opportunistic yeast associated with multiple infections, which was first reported in 2009 in Tokyo, Japan. Provided that it has great antifungal resistance to azoles and amphotericin B, its treatment options are limited, and therefore an empiric therapy using echinocandins such as micafungin should be considered. Case presentation: A rare case of a 48-year-old male patient with osteomyelitis caused by C. auris was reported in the city of Popayán, Colombia. The patient had a history of fem-oral head fracture, paraplegia due to firearm-related injury and neurogenic bladder, and reported having experienced abundant purulent foul-smelling secretions through trochanteric right ulcer for 15 days. MRI images revealed myositis and bone intensity alterations, which allowed diagnosing him with osteomyelitis. Due to repeated isolations of C. haemulonii in several bone samples, antifungal management was initiated. However, since no improvement in the patient’s condition was observed, a culture was sent to the Colombian National Institute of Health to identify the pathogen considering the repeated isolations of C. haemulonii and its apparent resistance to antifun-gals. C. auris was finally confirmed as the pathogen. Conclusion: Osteomyelitis by C. auris is a rare entity, which must be considered when treating patients with predisposing risk factors such as long hospital stays, bearing in mind that this is an inpatient-associated opportunistic infection.