1887
Volume 2023, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

infections of the appendicular skeleton are rare. A 72-year-old female presented with pain and deformity in her left lower limb and an inability to bear weight that had persisted for the last six months. A femur biopsy confirmed the diagnosis of extensive osteomyelitis, and the patient was treated with amphotericin B and oral voriconazole. The patient died of COVID-19 after 2.5 months of treatment. A diagnosis of osteomyelitis may be delayed because of its varied clinical presentation. To the best of our knowledge, this is the first known case of de novo neglected and extensive (multisite, multibone) osteomyelitis in an immunocompetent patient. This case highlights the importance of awareness in patients and treating physicians of this rare infection and its early diagnosis to prevent extensive spread.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2023.25
2023-09-23
2024-11-09
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2023/3/qmj.2023.25.html?itemId=/content/journals/10.5339/qmj.2023.25&mimeType=html&fmt=ahah

References

  1. Bariteau JT, Waryasz GR, McDonnell M, Fischer SA, Hayda RA, Born CT. Fungal osteomyelitis and septic arthritis. J Am Acad Orthop Surg. 2014; 22::390–401. doi: 10.5435/JAAOS-22-06-390
    [Google Scholar]
  2. Uehara Y, Kasai H, Nakajima T, Tanabe N, Tatsumi K, Yoshino I. Aspergillus osteomyelitis developed from chronic pulmonary aspergillosis as a late complication to lobectomy for lung cancer. Intern Med. 2018; 57::2991–4. doi: 10.2169/internal medicine.0334-17
    [Google Scholar]
  3. Gamaletsou MN, Rammaert B, Bueno MA, Moriyama B, Sipsas NV, Kontoyiannis DP, et al.. Aspergillus osteomyelitis: epidemiology, clinical manifestations, management, and outcome. J Infect. 2014; 68::478–93. doi: 10.1016/j.jinf.2013.12.008
    [Google Scholar]
  4. Segal BH. Aspergillosis. N Engl J Med. 2009; 360::1870–84. doi: 10.1056/NEJMra0808853
    [Google Scholar]
  5. Gabrielli E, Fothergill AW, Brescini L, Sutton DA, Marchionni E, Orsetti E, et al.. Osteomyelitis caused by Aspergillus species: a review of 310 reported cases. Clin Microbiol Infect. 2014; 20::559–65. doi: 10.1111/1469-0691.12389
    [Google Scholar]
  6. Koehler P, Tacke D, Cornely OA. Aspergillosis of bones and joints – a review from 2002 until today. Mycoses. 2014; 57::323–35. doi: 10.1111/myc.12165
    [Google Scholar]
  7. Hébert-Seropian S, Pelet S. Aspergillus osteomyelitis of the scapula-a case report. JBJS Case Connect. 2020; 10::e0343. doi: 10.2106/JBJS.CC.19.00343
    [Google Scholar]
  8. Denning DW, Stevens DA. Antifungal and surgical treatment of invasive Aspergillosis: review of 2121 published cases. Rev Infect Dis. 1990; 12::1147–201. doi: 10.1093/clinids/12.6.1147
    [Google Scholar]
  9. Stratov I, Korman TM, Johnson PD. Management of Aspergillus osteomyelitis: Report of failure of liposomal amphotericin B and response to voriconazole in an immunocompetent host and literature review. Eur J Clin Microbiol Infect Dis. 2003; 22::77–83. doi: 10.1007/s10096-003-0909-3
    [Google Scholar]
  10. Mouas H, Lutsar I, Dupont B, Fain O, Herbrecht R, Lescure FX, et al.. Voriconazole for invasive bone aspergillosis: a worldwide experience of 20 cases. Clin Infect Dis. 2005; 40::1141–7. doi: 10.1086/428734
    [Google Scholar]
  11. Koutserimpas C, Chamakioti I, Raptis K, Alpantaki K, Vrioni G, Samonis G. Osseous infections caused by Aspergillus species. Diagnostics. 2022; 12::201. doi: 10.3390/diagnostics12010201
    [Google Scholar]
  12. Koutserimpas C, Chamakioti I, Naoum S, Raptis K, Alpantaki K, Kofteridis DP, et al.. Spondylodiscitis caused by Aspergillus species. Diagnostics. 2021; 11::1899. doi: 10.3390/diagnostics11101899
    [Google Scholar]
  13. Latgé JP, Chamilos G. Aspergillus fumigatus and Aspergillosis in 2019. Clin Microbiol Rev. 2019; 33::e140–118. doi: 10.1128/CMR.00140-18
    [Google Scholar]
  14. D’sa SR, Singh S, Satyendra S, Mathews P. Case report of Aspergillus osteomyelitis of the ribs in an immunocompetent patient. J Glob Infect Dis. 2013; 5::118–20. doi: 10.4103/0974-777X.116875
    [Google Scholar]
  15. Gautier M, Normand AC, Ranque S. Previously unknown species of Aspergillus. Clin Microbiol Infect. 2016; 22::662–9. doi: 10.1016/j.cmi.2016.05.013
    [Google Scholar]
  16. Cadena J, Thompson GR, Patterson TF. Aspergillosis: Epidemiology, diagnosis, and treatment. Infect Dis Clin N Am. 2021; 35::415–34. doi: 10.1016/j.idc.2021.03.008
    [Google Scholar]
  17. Jerome T, Kandasamy L, Terrence T, Bhalaji S, Shanmugasundaram B. Aspergillus flavus infection of lower limb in an immune-competent patient. Cureus. 2020; 12::e9342. doi: 10.7759/cureus.9342
    [Google Scholar]
  18. Lee YJ, Sadigh S, Mankad K, Kapse N, Rajeswaran G. The imaging of osteomyelitis. Quantitative Imaging Med Surg. 2016; 6::184–98. doi: 10.21037/qims.2016.04.01
    [Google Scholar]
  19. Anwer U, Yablon CM. Imaging of osteomyelitis of the extremities. Semin Roentgenol. 2017; 52::49–54. doi: 10.1053/j.ro.2016.05.011
    [Google Scholar]
  20. Ma H, Lv G, Wang B. Does surgery influence the outcome of Aspergillus osteomyelitis? Clin Microbiol Infect. 2014; 20::O788. doi: 10.1111/1469-0691.12588
    [Google Scholar]
/content/journals/10.5339/qmj.2023.25
Loading
/content/journals/10.5339/qmj.2023.25
Loading

Data & Media loading...

  • Article Type: Case Report
Keyword(s): antifungalAspergillosisfemur and osteomyelitis
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error