Sacral Colpopexy Followed by Refractory Candida albicans Osteomyelitis and Discitis Requiring Extensive Spinal Surgery

University of California, San Diego, Department of Reproductive Medicine, Division of Female Pelvic Medicine and Reconstructive Surgery, San Diego, California, USA.
Obstetrics and Gynecology (Impact Factor: 5.18). 08/2012; 120(2 Pt 2):464-8. DOI: 10.1097/AOG.0b013e318256989e
Source: PubMed


Sacral colpopexy is an effective approach to treat vaginal vault prolapse. We report a case of serious Candida albicans infection at the site of sacral mesh attachment.
A 63-year-old woman developed back pain 4 months after sacral colpopexy. Imaging revealed L5 and S1 osteomyelitis and discitis. This was refractory to medical management and surgical debridement with mesh removal and tissue excision in the surgical plane. Cultures demonstrated C albicans. This ultimately required extensive spinal surgery, including two discectomies, L5 corpectomy, partial corpectomies, canal decompression, strut fusion, and posterior screw and rod stabilization and fusion.
C albicans lumbosacral osteomyelitis and discitis is a rare but serious complication after sacral colpopexy that can result in significant morbidity.

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Available from: Charles W Nager, Feb 10, 2015
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    • "Spondylodiscitis is rare, but its consequences might be devastating with a wide spectrum of disability and severe pain. Spondylodiscitis cases following SC procedures were identified with microbial pathogen related mechanisms in several papers [7] [8] [10] [11]. However, in a recent review, Propst et al. [10] reported that only 29% (8/28) of the cases could be treated with antibiotics despite positive culture results. "

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