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1000
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Abstract/Summary
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<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Objectives</jats:title>
<jats:p>Knowledge of <jats:italic>Candida</jats:italic> spondylodiscitis is limited to case reports and smaller case series. Controversy remains on the most effective diagnostical and therapeutical steps once <jats:italic>Candida</jats:italic> is suspected. This systematic review summarized all cases of <jats:italic>Candida</jats:italic> spondylodiscitis reported to date concerning baseline demographics, symptoms, treatment, and prognostic factors.</jats:p>
</jats:sec><jats:sec>
<jats:title>Methods</jats:title>
<jats:p>A PRISMA-based search of PubMed, Web of Science, Embase, Scopus, and OVID Medline was performed from database inception to November 30, 2022. Reported cases of <jats:italic>Candida</jats:italic> spondylodiscitis were included regardless of <jats:italic>Candida</jats:italic> strain or spinal levels involved. Based on these criteria, 656 studies were analyzed and 72 included for analysis. Kaplan-Meier curves, Fisher’s exact, and Wilcoxon’s rank sum tests were performed.</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>In total, 89 patients (67% males) treated for <jats:italic>Candida</jats:italic> spondylodiscitis were included. Median age was 61 years, 23% were immunocompromised, and 15% IV drug users. Median length of antifungal treatment was six months, and fluconazole (68%) most commonly used. Thirteen percent underwent debridement, 34% discectomy with and 21% without additional instrumentation. Median follow-up was 12 months. The two year survivorship free of death was 80%. The two year survivorship free of revision was 94%. Younger age (<jats:italic>p</jats:italic> = 0.042) and longer length of antifungal treatment (<jats:italic>p</jats:italic> = 0.061) were predictive of survival.</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusion</jats:title>
<jats:p>Most patients affected by <jats:italic>Candida</jats:italic> spondylodiscitis were males in their sixties, with one in four being immunocompromised. While one in five patients died within two years of diagnosis, younger age and prolonged antifungal treatment might play a protective role.</jats:p>
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1000
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Hinweis
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DeepGreen-ID: 850d20c9e93a469fa79aafdb66d4fc0a ; metadata provieded by: DeepGreen (https://www.oa-deepgreen.de/api/v1/), LIVIVO search scope life sciences (http://z3950.zbmed.de:6210/livivo), Crossref Unified Resource API (https://api.crossref.org/swagger-ui/index.html), to.science.api (https://frl.publisso.de/), ZDB JSON-API (beta) (https://zeitschriftendatenbank.de/api/), lobid - Dateninfrastruktur für Bibliotheken (https://lobid.org/resources/search)
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