1. Osteomyelitis caused by Aspergillus species: a review of 310 reported cases
- Author
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Elena Orsetti, Deanna A. Sutton, E. Marchionni, Francesco Barchiesi, Rosaria Gesuita, E. Gabrielli, Annette W. Fothergill, Lucia Brescini, Pamela Castelli, and Silvia Staffolani
- Subjects
Microbiology (medical) ,medicine.medical_specialty ,Antifungal Agents ,Itraconazole ,Antifungal drug ,Comorbidity ,Aspergillosis ,Gastroenterology ,Aspergillus fumigatus ,Amphotericin B ,Internal medicine ,medicine ,Humans ,aspergillosis ,Demography ,Voriconazole ,Antifungals ,biology ,Osteomyelitis ,osteomyelitis ,General Medicine ,medicine.disease ,biology.organism_classification ,Combined Modality Therapy ,Survival Analysis ,Surgery ,Transplantation ,Aspergillus ,Infectious Diseases ,Debridement ,immunosuppressed patients ,spondylodiscitis ,medicine.drug - Abstract
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 percent 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%.
- Published
- 2014