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CASE REPORT
Candida albicans osteomyelitis as a cause of chest pain and visual loss
  1. Rita Magano1,
  2. Joana Cortez1,
  3. Evelise Ramos2,
  4. Luís Trindade1
  1. 1Department of Infectious Disease, Coimbra's Hospital Centre and University, Coimbra, Portugal
  2. 2Clinica Vida Cligeste, Luanda, Angola
  1. Correspondence to Dr Rita Magano, rita.magano{at}gmail.com

Summary

Candida albicans osteomyelitis is a rare disease that occurs in immunocompromised individuals, sometimes with a late diagnosis related to the mismatch between symptoms and candidemia. This case refers to a 36-year-old male patient with a history of oesophageal surgery for achalasia with multiple subsequent surgeries and hospitalisation in the intensive care unit for oesophageal fistula complication. Four months after discharge, the patient was admitted to the infectious diseases department with pain in the 10th–12th left ribs, swelling of the 4th–6th costal cartilage and decreased visual acuity. An MRI study showed thickening and diffuse enhancement, with no defined borders in the cartilage and ribs, compatible with infection. After performing a CT-guided bone biopsy, isolated C. albicans sensitive to antifungal agents was detected. The patient started therapy with liposomal amphotericin B and maintenance fluconazole for 6 months and showed clinical and radiological improvement within this time.

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