Osteomyelitis caused by Aspergillus species: a review of 310 reported cases. (15th October 2013)

• Record Type: Journal Article
• Authors: Gabrielli, E.; Fothergill, A. W.; Brescini, L.; Sutton, D. A.; Marchionni, E.; Orsetti, E.; Staffolani, S.; Castelli, P.; Gesuita, R.; Barchiesi, F.; Roilides, E.
• Is Part Of: Clinical microbiology and infection. Volume 20:Number 6(2014:Jun.)
• Page Start: 559
• Page End: 565
• Publication Date: 2013-10-15
• Subjects: Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1111/1469-0691.12389
• Languages: English
• ISSNs: 1198-743X

Abstract

<abstract abstract-type="main" id="clm12389-abs-0001"> <title>Abstract</title> <p> <italic>Aspergillus</italic> 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 <italic>Aspergillus fumigatus</italic> (55%), <italic>Aspergillus flavus</italic> (12%), and <italic>Aspergillus nidulans</italic> (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%.</p> </abstract>