A 29-year-old male who used parenteral drugs and was diagnosed with HIV infection and was under high-resolution antiretroviral treatment.
In the anamnesis, the patient reported, for about three weeks, anorexia, tiredness, weight loss quantified in 3-4 kg, fever (39 °C) with characteristic chills and intense pain located in the dorsal region.
Physical examination revealed poor general condition, with signs of peripheral venipuncture and pain upon palpation and percussion of the last dorsal vertebrae.
Leukocytes, leukocyte formula, hemoglobin, hematocrit and platelets showed no alterations.
ESR of 50 mm in the first hour.
Pathogen 495 mg/dL (N: 200-450) and other coagulation parameters, biochemistry and elemental urine analysis were normal.
The determinations of CD4 lymphocyte subpopulations were 627/mm3 and the HIV viral load was undetectable.
In microbiological studies, blood cultures and serology of brucella were negative.
Eye fundus and electromyography did not show significant findings; vegetations were not observed in the echocardiographic examination.
The MRI of the spine showed signs of morphological alteration of the bodies D9-D10, with disk disappearance and presence of mass disappearance.
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Direct puncture of the mass was performed and purulent material was obtained and subjected to microbiological examination, with negative AFB determination and positive culture for Candida albicans.
Sequential treatment was administered with liposomal amphotericin B at a dose of 200 mg/day for 15 days, followed by fluconazole 200 mg/day for a total of 6 months, evolving with good clinical and radiological response with marked improvement of the lesion.
