Cryptococcal Osteomyelitis in an Adolescent Survivor of T-Cell Acute Lymphoblastic Leukemia

Oh, Djin-Ye; Madhusoodhan, P. Pallavi; Springer, Deborah J.; Inglima, Kenneth; Chaudhri, Ali; Heitman, Joseph; Raetz, Elizabeth A.; Khaitan, Alka; Rigaud, Mona

doi:10.1097/inf.0000000000000687

Cited by 7 publications

(4 citation statements)

References 38 publications

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“…We identified an additional 39 cases with cryptococcal osteomyelitis and the general characteristics of these patients are listed in Table . Bony involvement due to Cryptococcus species is uncommon, with an estimated prevalence of 5% and is usually seen in association with multi‐organ disseminated disease.…”

Section: Literature Review and Discussionmentioning

confidence: 99%

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

Medaris

Ponce

Hyde

et al. 2016

Mycoses

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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.

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Section: Literature Review and Discussionmentioning

confidence: 99%

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

Medaris

Ponce

Hyde

et al. 2016

Mycoses

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“…The disease appears to be even more infrequent in children, though 17 cases have been recorded [ 2 , 83 , 84 ]. As with adults, HIV-positive children are more prone to suffering from such a condition.…”

Section: Review Of the Literaturementioning

confidence: 99%

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

et al. 2023

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Introduction Osteomyelitis is a bone inflammation that can be related to various infectious agents. As with any other type of inflammation, the prevailing symptoms and signs may include redness, swelling, pain, and heat. Fungal osteomyelitis is rare and usually found in immune-compromised patients. Case presentation A non-human immunodeficiency virus immunocompromised Greek female patient, 82 years old, visited the emergency department due to a 3 day pain located mainly over the left tibia’s anterior surface, accompanied by swelling and redness. There was also a subcutaneous lesion of her left breast. Medical history revealed that the patient had an unmasked close contact with pigeons, a main host of the disease. Initial x-ray imaging showed an osteolytic area in the upper third of the tibial diaphysis. The patient was admitted and underwent a computed tomography-guided biopsy. The specimen revealed a Cryptococcus neoformans infection of the bone and the breast. She was treated with 400 mg fluconazole twice a day for 3 weeks while in hospital and 200 mg twice a day upon discharge for 9 months. After that, she underwent surgical debridement because of lasting local irritation. She was closely monitored in our outpatient office, and in her last visit, 1 year after the initial admission, inflammatory signs had regressed vastly. Conclusions To our knowledge, this is the ninth cryptococcal osteomyelitis of the tibia to be recorded since 1974, and the most unusual finding was the bifocal nature of the infection, affecting both the tibia and the breast.

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“…This patient's bone transplantation resulted in satisfactory bone healing; however, it should be noted there was extensive bone destruction in the whole body due to osteogenesis. Previous studies of patients with ALL have confirmed that before treatment, bone destruction is mainly caused by leukemia cells, and the lesions are more serious; however, after chemotherapy, bone destruction occurs because chemotherapy drugs inhibit bone synthesis and promote bone absorption (2,3,9). After 4 months of chemotherapy, accompanied by osteoporosis and the destruction of multiple parts of the body, the patient achieved satisfactory boniness, which also confirmed that Masquelet technology combined with free fibula transplantation effectively improved the quality of bone healing.…”

Section: B C D Amentioning

confidence: 99%

“…Very few patients with acute lymphoblastic leukemia (ALL) experience complications with osteomyelitis during chemotherapy (1)(2)(3)(4)(5)(6). Recurrent ALL for which the first symptom is osteomyelitis involving the entire long bone is very rare.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of recurrent acute lymphoblastic leukemia with humeral osteomyelitis as the first symptom: a case report and literature review

Liu¹,

Zhang²,

Shen³

et al. 2021

Ann Transl Med

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Osteomyelitis is a complication of acute lymphoblastic leukemia (ALL); however, its incidence rate is low. Recurrent ALL for which osteomyelitis is the first manifestation is rarer still. The repair and reconstruction of segmental bone defects caused by infection is a clinical problem. This article reports a rare case study of a 22-year-old male patient with recurrent ALL for which right humeral osteomyelitis was the first symptom including chills at first, recurrent fever and chills then, purulence from poster lateral right upper arm finally. Before treatment, the patient concealed his previous history of ALL. Debridement was performed, and the Masquelet technique and free fibula transplantation were used to reconstruct the humerus. ALL recurred with extensive bone invasion throughout the body 10 weeks after the humeral reconstruction. Despite the success of bone marrow transplantation, the patient died of complications. A limited follow-up period reveled that while leukemia extensively affected the bones of the patient's body, the reconstruction of the humerus was successful, and bone healing was good. This case study suggests that atypical or unexplained osteoarticular infection may be the precursor to some systemic diseases, and that Masquelet technology combined with free fibula transplantation is one of the best choices to treat segmental bone defects.

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Cryptococcal Osteomyelitis in an Adolescent Survivor of T-Cell Acute Lymphoblastic Leukemia

Cited by 7 publications

References 38 publications

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

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

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

Surgical treatment of recurrent acute lymphoblastic leukemia with humeral osteomyelitis as the first symptom: a case report and literature review

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