Successful treatment of Candida tropicalis osteomyelitis with Micafungin in a leukemia patient

The incidence of invasive candidal infection is increasing. The widespread use of central intravascular catheters, invasive procedures, immunosuppression, diabetes mellitus, total parenteral nutrition, broad-spectrum antibiotics and drugs abuse predispose patients to the infection. Eye, kidney, liver, skin, cardiac and brain infections are the most common site of invasive candidiasis while vertebral osteomyelitis is rare. Most Candida vertebral osteomyelitis is caused by Candida albicans. Less common organisms include C. tropicalis, C. glabrata and C. parapsilosis [1]. Both amphotericin B and the azoles have a role in the treatment, but treatment failure with either agent had been reported [2,3]. Micafungin belongs to echinocandins, and interferes with the synthesis of fungal cell wall. We report a Candida tropicalis infection manifested with osteomyelitis following a previous candidemia in a leukemia patient who was successfully treated by Micafungin.