Cryptococcal osteomyelitis: a report of 5 cases and a review of the recent literature

Leigh Ann Medaris; Brent Ponce; Zane Hyde; Dennis Delgado; David Ennis; William Lapidus; Matthew Larrison; Peter G Pappas

doi:10.1111/myc.12476

Cryptococcal osteomyelitis: a report of 5 cases and a review of the recent literature

Mycoses. 2016 Jun;59(6):334-42. doi: 10.1111/myc.12476. Epub 2016 Mar 10.

Authors

Leigh Ann Medaris¹, Brent Ponce², Zane Hyde², Dennis Delgado¹, David Ennis³, William Lapidus⁴, Matthew Larrison⁵, Peter G Pappas¹

Affiliations

¹ Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
² Division of Orthopedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
³ Division of Infectious Diseases, Trinity Medical Center, Birmingham, AL, USA.
⁴ Division of Infectious Diseases, Brookwood Medical Center, Birmingham, AL, USA.
⁵ Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.

PMID: 26968335
DOI: 10.1111/myc.12476

Abstract

Cryptococcus neoformans is a fungal pathogen associated with advanced HIV disease and other disorders associated with immune dysfunction. The pulmonary and the central nervous system are the most common manifestations of the disease. Localised osteomyelitis as the sole manifestation of extrapulmonary disease is rare. Herein, we present five cases of Cryptococcus osteomyelitis as the only manifestation of extrapulmonary disease. We also identified 84 additional cases of isolated cryptococcal osteomyelitis in the literature. Using these data, we have made some general recommendations regarding an approach to treatment of this uncommon clinical entity.

Keywords: Cryptococcosis; Cryptococcus neoformans; osteomyelitis.

Publication types

Case Reports
Review

MeSH terms

Adolescent
Adult
Aged
Amphotericin B / therapeutic use
Antifungal Agents / therapeutic use
Child, Preschool
Cryptococcosis / diagnosis*
Cryptococcosis / diagnostic imaging
Cryptococcosis / drug therapy*
Cryptococcosis / microbiology
Cryptococcus neoformans / isolation & purification
Cryptococcus neoformans / ultrastructure
Female
HIV Infections / complications
HIV Infections / microbiology
Hepatitis C / complications
Hepatitis C / microbiology
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Osteomyelitis / diagnosis
Osteomyelitis / diagnostic imaging
Osteomyelitis / drug therapy
Osteomyelitis / microbiology*
Sarcoidosis / complications
Sarcoidosis / microbiology
Tomography, X-Ray Computed
Young Adult

Substances

Antifungal Agents
Amphotericin B