Femur Osteomyelitis Due to a Mixed Fungal Infection in a Previously Healthy Man

Cimerman, Matej; Gunde‐Cimerman, Nina; Zalar, Polona; Perković, Tomislav

doi:10.1128/jcm.37.5.1532-1535.1999

Cited by 30 publications

(13 citation statements)

References 13 publications

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“…In a prospective study of 658 consecutive total hip arthroplasty procedures in which cultures were taken at surgery, Aspergillus was recovered in 4.1% of cases, and Aspergillus was also cultivated from the air in the operating theatre [255]. In another report, a male aged 22 years developed Aspergillus osteomyelitis after a closed fracture of the femur and subsequent surgery [256]. Another male, aged 16 years, developed infection with A. flavus following surgery for a fracture of the femur.…”

Section: Literature Reviewmentioning

confidence: 99%

Post-operative aspergillosis

Pasqualotto

Denning

2006

Clinical Microbiology and Infection

160

173

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While invasive aspergillosis occurs typically in severely immunocompromised patients, cases of surgical site infection have been reported in immunocompetent individuals. The Medline, LILACS and EMBASE databases were searched for descriptions of cases of post-operative aspergillosis, and references from relevant articles and conference abstracts were reviewed. More than 500 cases of post-operative aspergillosis were found. Cardiac surgery (n = 188), ophthalmological surgery (n > 90) and dental surgery (n > 100) were associated with the majority of cases. Other cases involved wound infections (n = 22), bronchial infections (n = 30), mediastinitis (n = 11), pleural aspergillosis (n = 1), infections following orthopaedic surgery (n = 42), vascular prosthetic surgery (n = 22), breast surgery (n = 5), abdominal surgery (n = 10) and neurosurgery (n = 25). In most patients, the source was presumed to be airborne infection during the surgical procedure. Prevention of these infections requires special care of the ventilation system in the operating room. Successful treatment requires rapid diagnosis, surgical debridement and antifungal therapy, often with voriconazole. In order to improve the outcome, better diagnostic methods are needed, particularly for cases of endocarditis and aortitis.

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Section: Literature Reviewmentioning

confidence: 99%

Post-operative aspergillosis

Pasqualotto

Denning

2006

Clinical Microbiology and Infection

160

173

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“…1 Antifungal treatment options for most IFDs include amphotericin B formulations, echinocandins, and triazole antifungal agents, although each may be associated with limitations that include pathogen susceptibility and patient tolerability. 2 Despite that IFDs in clinical practice usually involve a single fungal pathogen, concurrent infections with more than one fungal species have been reported in case studies [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] and retrospective analyses. [18][19][20] A multiple-species IFD may pose a unique clinical challenge because of the potential for increased virulence and different susceptibility profiles of the pathogens.…”

Section: Introductionmentioning

confidence: 99%

Isavuconazole for treatment of invasive fungal diseases caused by more than one fungal species

Marty

Cornely

Mullane

et al. 2018

Mycoses

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The optimal approach to treat invasive fungal disease (IFD) caused by more than one fungal species is unknown. We documented the efficacy and safety of isavuconazole for treatment of IFDs caused by more than one fungal species. VITAL was a single-arm, international, open-label study evaluating the efficacy and safety of isavuconazole (200 mg orally or intravenously every 8 hours for 48 hours, then once daily) for treatment of rare IFDs. The primary outcome was the overall response at Day 42; key secondary outcomes were overall responses at Day 84 and end of treatment (EOT), mortality at Days 42 and 84, and safety. This analysis includes patients with IFD caused by multiple fungal species. Fifteen patients were included in this analysis (including Aspergillus spp., n = 11; without Aspergillus spp., n = 4); median treatment duration was 97 days [range, 6-544] days). Overall treatment success was observed in 2/15 patients (13.3%) at Days 42 and 84, and 2/14 (14.3%) at EOT. All-cause mortality was 2/15 (13.3%) at Day 42 and 4/15 (26.7%) at Day 84. All patients had ≥1 treatment-emergent adverse event (TEAE); 12 patients (80.0%) had serious TEAEs; TEAEs led to discontinuation of isavuconazole in two patients (13.3%). Isavuconazole may be useful to treat some IFDs caused by multiple fungal species.

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“…Among the extrapulmonary locations, bone is rarely involved. Osteomyelitis caused by Aspergillus species is an infection that is often neglected, and data concerning risk factors, therapies and outcome are lacking . Therefore, in order to improve our knowledge of this unusual infection, we reviewed the data presented in the literature concerning this type of IA.…”

Section: Introductionmentioning

confidence: 99%

Osteomyelitis caused by Aspergillus species: a review of 310 reported cases

Gabrielli

Fothergill

Brescini

et al. 2014

Clinical Microbiology and Infection

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Aspergillus osteomyelitis is a rare infection. We reviewed 310 individual cases reported in the literature from 1936 to 2013. The median age of patients was 43 years (range, 0-86 years), and 59% were males. Comorbidities associated with this infection included chronic granulomatous disease (19%), haematological malignancies (11%), transplantation (11%), diabetes (6%), pulmonary disease (4%), steroid therapy (4%), and human immunodeficiency virus infection (4%). Sites of infection included the spine (49%), base of the skull, paranasal sinuses and jaw (18%), ribs (9%), long bones (9%), sternum (5%), and chest wall (4%). The most common infecting species were Aspergillus fumigatus (55%), Aspergillus flavus (12%), and Aspergillus nidulans (7%). Sixty-two per cent of the individual cases were treated with a combination of an antifungal regimen and surgery. Amphotericin B was the antifungal drug most commonly used, followed by itraconazole and voriconazole. Several combination or sequential therapies were also used experimentally. The overall crude mortality rate was 25%.

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Femur Osteomyelitis Due to a Mixed Fungal Infection in a Previously Healthy Man

Cited by 30 publications

References 13 publications

Post-operative aspergillosis

Post-operative aspergillosis

Isavuconazole for treatment of invasive fungal diseases caused by more than one fungal species

Osteomyelitis caused by Aspergillus species: a review of 310 reported cases

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