Abstract
An 83-year-old man underwent partial excision of the colon for a cancer of the descending colon on December 5, 1990. On the 8th postoperative day the patient suddenly had a fever. A fungus was detected at the tip of a catheter used for intravenous hyperalimantation, however, blood culture resulted in negative, and no antimycotic agent was administered. Around one month after operation lumbago and pains at the lower extremities developed. Paralysis of the lower half of the body occurred around 90 days after surgery. High levels of mycotic index and serum Darabinitol were shown. Candida tropicalis was isolated from the cerebrospinal fluid. Roentgenography revealed a destroyed picture of pyramid in the 6 and 7th thoracic vertebrae and in 4 and 5th lumbar vertebrae, and an irregular narrowing of the intervertebral disc. MRI showed an extrinsic pressure coming from the anterior on the spinal cord at the 6 and 7th thoracic vertebrae. The patient was diagnosed as candidiasis spondylitis and candidiasis meningitis. He could recover after 4-month administration of antimycotic agents. This extremely rare case of mycosis profunda which might be caused by a catherter used for intravenlous hyperalimentation is described, together with a review of the literature.
