Non-Candida Fungal Prosthetic Joint Infections

Koutserimpas, Christos; Chamakioti, Ifigeneia; Zervakis, S; Raptis, Konstantinos; Alpantaki, Kalliopi; Kofteridis, Diamantis P.; Vrioni, Georgia; Samonis, George

doi:10.3390/diagnostics11081410

Cited by 21 publications

(37 citation statements)

References 39 publications

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“…Aspergillus species are found worldwide in soil and decaying matter [76,80,[92][93][94]. Invasive Aspergillus infections are most commonly observed in patients with significant underlying immunosuppression [92,93]. In the present review, most patients were immunocompromised (76.3%).…”

Section: Discussionmentioning

confidence: 64%

“…The present study reviewed 118 patients and 119 isolated Aspergillus species, with 16 months of follow-up, during an 84-year period. Aspergillus species are found worldwide in soil and decaying matter [76,80,[92][93][94]. Invasive Aspergillus infections are most commonly observed in patients with significant underlying immunosuppression [92,93].…”

Section: Discussionmentioning

confidence: 99%

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Spondylodiscitis Caused by Aspergillus Species

et al. 2021

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Background: Spondylodiscitis caused by Aspergillus spp. is a rare but life-threatening clinical entity. However, a consensus on diagnostic criteria and most effective medical management is still missing. The present study is a review of all published cases of spondylodiscitis caused by Aspergillus spp., in an effort to elucidate epidemiology, patients’ characteristics, andand the medical and surgical treatment options and their effectiveness. Methods: A thorough review of all existing spondylodiscitis cases caused by Aspergillus was performed. Data regarding demographics, responsible fungus, time between symptoms’ onset and firm diagnosis, antifungal treatment (AFT), surgical intervention, andand the infection’s outcome were investigated. Results: A total of 118 Aspergillus spondylodiscitis cases, yielding 119 Aspergillus spp. isolates, were identified in the literature. The patients’ mean age was 40.6 years. Magnetic resonance imaging (MRI) (after its introduction) indicated the diagnosis in most cases (66.7%), while definite diagnosis was established through cultures in the majority of cases (73.7%). Aspergillus fumigatus was isolated in most cases (73; 61.3%), followed by Aspergillus flavus (15; 12.6%) andand Aspergillus nidulans and terreus (7; 5.9%, each). The mean time between symptoms’ onset and diagnosis was 5.7 months. Amphotericin B was the preferred antifungal regiment (84 cases; 71.2%), followed by voriconazole (31; 26.3%), and the mean AFT duration was 6.1 months. The final outcome was successful in 93 cases (78.8%). Furthermore, 77 patients (65.3%) underwent surgery. Conclusions: Spondylodiscitis caused by Aspergillus spp. represents a clinical challenge, requiring a multidisciplinary approach. The present review has shown that prolonged AFT has been the standard of care of the studied cases, while surgical treatment seems to play an important role in selected patents.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Spondylodiscitis Caused by Aspergillus Species

et al. 2021

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“…Fungal septic arthritis represents a rare and severe, even life-threatening, infection. It requires long-term medical, as well as, in most cases surgical treatment [ 5 , 30 ]. Aspergillosis is not a common infection.…”

Section: Discussionmentioning

confidence: 99%

“…Aspergillus species are commonly present in soil and decaying matter [ 5 , 34 ]. Invasive Aspergillosis is, most often, reported in immunocompromised hosts [ 5 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

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Native Joint Infections by Aspergillus Species

et al. 2021

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Background: Septic arthritis due to Aspergillus spp. represents a rare, but severe disease. Nevertheless, clear guidelines regarding most effective medical treatment have not yet been established. The present study is a literature review of all reported cases of fungal septic arthritis due to Aspergillus spp, in order to clarify epidemiology, as well as the medical and operative management and their outcome. Methods: A meticulous review of all published septic arthritis infections due to Aspergillus has been conducted. Information regarding demographics, causative fungus, antifungal treatment (AFT), surgical intervention, as well as the infection’s outcome were recorded and evaluated. Results: A total of 30 Aspergillus spp. strains from 29 hosts have been studied. The patients’ mean age was 45.8 years. The most commonly affected joint was the knee (45.7%), while the predominant symptom was joint pain (62%). Most patients were immunocompromised (72.4%). Diagnosis was established through cultures and/or histopathology. Aspergillus fumigatus was the most common responsible fungi (63.3%), followed by A. flavus (16.6%) and A. terreus (10%). Regarding AFT, the preferred agent proved to be Amphotericin B (14 cases; 48.3%), followed by voriconazole (11; 37.9%), while the mean AFT duration was 5.6 months. In most cases surgical treatment was also performed (in 4 cases no surgery was reported). Treatment was effective in 20 cases (69%). Conclusions: Septic arthritis caused by Aspergillus spp. represents a severe clinical entity. It seems that, with the available data, prolonged AFT along with surgical intervention is the preferred management of this infection, while identification of the responsible fungus is of utmost importance.

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