Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

Salvage Therapy with Rezafungin for Candida parapsilosis Spondylodiscitis: a Case Report from Expanded Access Program

Giulio Viceconte
* ,
Antonio Riccardo Buonomo
ORCID logo ,
Nunzia Esposito
,
Letizia Cattaneo
,
Teresa Somma
,
Maria Michela Scirocco
,
Ciro Gabriele Mainolfi
,
Ivan Gentile
ORCID logo
Version 1 : Received: 15 April 2024 / Approved: 15 April 2024 / Online: 16 April 2024 (16:24:16 CEST)

How to cite: Viceconte, G.; Buonomo, A.R.; Esposito, N.; Cattaneo, L.; Somma, T.; Scirocco, M.M.; Mainolfi, C.G.; Gentile, I. Salvage Therapy with Rezafungin for Candida parapsilosis Spondylodiscitis: a Case Report from Expanded Access Program. Preprints 2024, 2024041015. https://doi.org/10.20944/preprints202404.1015.v1 Viceconte, G.; Buonomo, A.R.; Esposito, N.; Cattaneo, L.; Somma, T.; Scirocco, M.M.; Mainolfi, C.G.; Gentile, I. Salvage Therapy with Rezafungin for Candida parapsilosis Spondylodiscitis: a Case Report from Expanded Access Program. Preprints 2024, 2024041015. https://doi.org/10.20944/preprints202404.1015.v1

Abstract

Candida spondylodiscitis (CS) is a rare disease, for which therapeutic option are limited to fluconazole or echinocandins and the treatment should be administered up to 12 months. In case of reduced azole susceptibility, there is a scarcity of therapeutic options with adequate bone penetration and limited toxicity. We report the first case of successful use of rezafungin for a spondylodiscitis due to Candida parapsilosis with reduced susceptibility to azoles. The patient, affected by paraplegia and short bowel syndrome, was diagnosed with CS with culture on vertebral biopsy guided by a 18-FDG-PET/CT scan. He received rezafungin 200 mg weekly for 26 weeks, after 10 weeks of previous antifungal treatment. He had a full clinical, radiologic and biochemical response to the therapy with rezafungin, with no adverse effects. Rezafungin is a promising therapy for Candida osteomyelitis, especially when first line therapies are ineffective or contraindicated.

Keywords

rezafungin; Candida; spondylodiscitis; osteomyelitis

Subject

Medicine and Pharmacology, Epidemiology and Infectious Diseases

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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