Clavicular Fracture-Associated Candida parapsilosis Osteomyelitis: A Case Report and State-of-the-Art Perspective.

Abstract

Candida parapsilosis is an infrequent opportunistic pathogen, responsible for approximately 7% of Candida osteomyelitis cases. While infections in immunocompetent individuals are rare, they present significant therapeutic challenges due to intrinsic resistance mechanisms and biofilm formation, requiring a multidisciplinary management approach. We report the case of a 27-year-old immunocompetent man who developed Candida parapsilosis osteomyelitis following surgical fixation of a clavicular fracture sustained in a road traffic accident. After multiple surgical interventions due to persistent infection, C. parapsilosis was identified in bone samples, along with Klebsiella pneumoniae. The patient underwent prolonged antifungal and antibiotic therapy, combined with surgical debridement and bone reconstruction using a microsurgical fibular flap. He remained clinically stable, with no signs of recurrence at 11-month follow-up. This case underscores the diagnostic and therapeutic challenges of Candida parapsilosis osteomyelitis, particularly in immunocompetent individuals, who are often not considered at risk for fungal infections. It highlights the importance of early clinical suspicion, prolonged microbiological cultures, and a multidisciplinary team approach integrating both surgical and medical management to optimize patient outcomes. Additionally, a review of the literature on C. parapsilosis osteomyelitis is provided.