Osteomyelitis is inflammation and destruction of bone caused by bacteria, mycobacteria, or fungi. Common symptoms are localized bone pain and tenderness with constitutional symptoms (in acute osteomyelitis) or without constitutional symptoms (in chronic osteomyelitis). Diagnosis is by imaging studies and cultures. Treatment is with antibiotics and sometimes surgery. Fifty-nine cases of candidal vertebral osteomyelitis that were not secondary to injection drug use were identified in adults.
The mean patient age was 55.8 years (range, 17–88 years). Men outnumbered women (61.5% vs. 38.5%). Many patients had several risk factors for candidemia: 10 patients had 4 risk factors, 16 patients had 3, 19 patients had 2, and 12 patients had only 1. Eight patients had none of the defined risk factors reported. Of these 8 patients, 2 had diabetes mellitus, 2 underwent spinal surgery, 1 had multiple transfusions for gastrointestinal bleeding, 1 had emphysema and atherosclerosis, 1 had liver cirrhosis, and 1 had undefined risk factor(s) In many cases, osteomyelitis can be effectively treated with antibiotics and pain medications. If a biopsy is obtained, this can help guide the choice of the best antibiotic. The duration of treatment of osteomyelitis with antibiotics is usually four to eight weeks