Criptococosis vertebral. Comunicación de un caso y revisión bibliográfica

Abstract

Vertebral cryptococosis. Case report and literature review Cryptococcosis is an infectious disease caused by a ubiquitous encapsulated yeast called Cryptococcus neoformans, it is usually associated with immunosuppressed patients. Osteomyelitis occurs in 5-10%, the spine involvement is one of the most reported. The purpose of this work is to present a case of isolated vertebral cryptococcosis and detail the results of a literature review. The treatment protocol is not yet established but it is recommended to start with aggressive intravenous therapy and continue with a suppressive treatment orally during a variable time. Surgical indication is considered in lesions that affect the spinal stability, deformity or neurological compromise and for local infectious control.

Malassezia restricta as an unexpected cause of infectious osteomyelitis diagnosed by metagenomic sequencing: a case report and literature review

“… unclear more than 24 months more than 5 years Improvement Lai et al [ 45 ] 25/M cryptococcal back pain Histopathological investigations from intra operative operative and drugs amphotericin B 4 weeks of intravenous amphotericin B and then 8 weeks of oral amphotericin B 3 months 9 months Improvement Zhong et al [ 46 ] 37/M Cryptococcus neoformans , progressive low-back and sacrococcygeal-pain biopsy of an abscess and culture examination drug fluconazole 4 weeks of intravenous fluconazole, then 8 weeks of oral fluconazole 3 months 8 months Full recovery Adsu et al [ 47 ] 45/F cryptococcal back pain Histopathological investigations from intra operative operative and drugs fluconazole, amphotericin B amphotericin B ntravenously for 3 months, oral fluconazole 400 mg once a day for 5 months. 8 months unclear Improvement Li .et al [ 48 ] 17/F cryptococcal back pain, fever, scoliosis Histopathological investigations from intra operative operative and drugs fluconazole fluconazole for 3months 3 months unclear Improvement Pereira-Duarte et al [ 49 ] 65/M...…”

Cryptococcal infection presenting as soft tissue abscess and arthritis

“…Surgical indication is considered in lesions that affect the spinal stability, deformity or neurological compromise, degenerative symptomatic arthritis, and some cases of meningitis, and for local infectious control. [17] Many authors have recommended systemic chemoprophylactic treatment preoperatively and postoperatively for patients who have had fungal arthritis, and it may be argued that antifungal chemotherapy should be used at the time of joint surgery in a patient who has had cryptococcal arthritis, even if the patient has been apparently free of the disease for a long period of time. [9] The usual prognosis with treatment is good, except in those patients with other concomitant disseminated opportunistic infections.…”

“…The standard treatment is not yet established but it is recommended to start with aggressive intravenous antifungal injection and continue with a suppressive treatment orally during a variable time depend on the patient status. Surgical indication is considered in lesions that affect the spinal stability, deformity or neurological compromise, degenerative symptomatic arthritis, and some cases of meningitis, and for local infectious control [17] . Many authors have recommended systemic chemoprophylactic treatment preoperatively and postoperatively for patients who have had fungal arthritis, and it may be argued that antifungal chemotherapy should be used at the time of joint surgery in a patient who has had cryptococcal arthritis, even if the patient has been apparently free of the disease for a long period of time [9] …”

Cryptococcus neoformans osteomyelitis of the tibia: a case report and review of the literature

“…Immune-compromised patients bear a higher risk of developing the cryptococcal disease, and osteomyelitis due to C. neoformans has no age predilection [ 11 ]. Isolated fungal osteomyelitis is a rare condition, usually affecting a sole vertebra [ 12 ]. As Li et al .…”

“…suggested [ 13 ], spinal involvement requires both MRI and laboratory tests to better assess both the pathogen and the lesion’s extent and nature. Surgical treatment should be considered in cases where spinal stability could be compromised [ 12 – 14 ]. Osseous involvement is as a sign of systemic dissemination in most cases.…”