Pseudotumoral Cutaneous Aspergillosis in Chronic Granulomatous Disease, Report of a Pediatric Case

Khémiri, M.; Fékih, N. El; Borgi, Aida; Kharfi, Monia; Boubaker, Samir; Barsaoui, Sihem

doi:10.1097/dad.0b013e3182562451

Cited by 9 publications

(5 citation statements)

References 11 publications

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“…Among the extrapulmonary locations, bone is rarely involved. Osteomyelitis caused by Aspergillus species is an infection that is often neglected, and data concerning risk factors, therapies and outcome are lacking . Therefore, in order to improve our knowledge of this unusual infection, we reviewed the data presented in the literature concerning this type of IA.…”

Section: Introductionmentioning

confidence: 99%

Osteomyelitis caused by Aspergillus species: a review of 310 reported cases

Gabrielli

Fothergill

Brescini

et al. 2014

Clinical Microbiology and Infection

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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 per cent 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%.

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Section: Introductionmentioning

confidence: 99%

Osteomyelitis caused by Aspergillus species: a review of 310 reported cases

Gabrielli

Fothergill

Brescini

et al. 2014

Clinical Microbiology and Infection

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“…A total of 63 patients (46 males; 73%), with a mean age of 37.9 years [standard deviation (SD) = 25.3], suffering osteomyelitis due to Aspergillus spp. were identified during the study period [ 1 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ].…”

Section: Resultsmentioning

confidence: 99%

Osseous Infections Caused by Aspergillus Species

et al. 2022

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Background: Osteomyelitis caused by Aspergillus spp. is a severe, but rare, clinical entity. However, clear guidelines regarding the most effective medical management have not yet been established. The present study is a literature review of all such cases, in an effort to elucidate epidemiology, as well as the therapeutic management and the infection’s outcome. Methods: A thorough review of all reports of osteomyelitis of the appendicular and the axial skeleton, without the skull and the spine, caused by Aspergillus spp. was undertaken. Data about demographics, imaging techniques facilitating diagnosis, causative Aspergillus, method of mold isolation, antifungal treatment (AFT), surgical treatment, as well as the infection’s outcome were recorded and evaluated. Results: A total of 63 cases of osseous infection due to Aspergillus spp. were identified. The studied population’s mean age was 37.9 years. The most commonly affected site was the rib cage (36.8%). Most hosts suffered immunosuppressive conditions (76.2%). Regarding imaging methods indicating diagnosis, computer tomography (CT) was performed in most cases (42.9%), followed by plain X-ray (41.3%) and magnetic resonance imaging (MRI) (34.9%). The most frequent isolated mold was Aspergillus fumigatus (49.2%). Cultures and/or histopathology were used for definite diagnosis in all cases, while galactomannan antigen test was additionally used in seven cases (11.1%), polymerase chain reaction (PCR) in four cases (6.3%), and beta-d-glucan testing in three cases (4.8%). Regarding AFT, the preferred antifungal was voriconazole (61.9%). Most patients underwent surgical debridement (63.5%). The outcome was successful in 77.5%. Discussion: Osteomyelitis due to Aspergillus spp. represents a severe infection. The available data suggest that prolonged AFT in combination with surgical debridement is the preferred management of this infection, while identification of the responsible mold is of paramount importance.

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“…Furthermore, Aspergillus species could be detected by wound smears, swab tests from auditory canals and cultures of purulent secretion . In histological analysis, multinucleated giant cells with vacuolated cytoplasm in haematoxylin–phloxine–saffron staining indicate fungal infection . Shelton and colleagues reported the appearance of calcium oxalate crystals associated with sign invasive A. niger infection .…”

Section: Methodsmentioning

confidence: 99%

“…However, concerning fungal osteomyelitis and joint infection little data are available. Based on our literature search four of 47 case reports detected galactomannan antigenaemia (Fig. ).…”

Section: Methodsmentioning

confidence: 99%

“…Distribution and development of A . osteomyelitis or joint infection are typically linked to haematogenous dissemination especially in patients with a history of invasive aspergillosis, immunocompromised patients, intravenous drug users and children with primary immunodeficiency, for example, CGD . Similar to bacterial osteomyelitis bone is often a secondary focus of infection as the primary localisation is situated elsewhere.…”

Section: Methodsmentioning

confidence: 99%

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Aspergillosis of bones and joints – a review from 2002 until today

Köehler

Tacke

Cornely

2014

Mycoses

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Poor clinical outcome and complicated neurological complications illustrate the severity of bone and joint infections with Aspergillus species. Host predisposing conditions are immunosuppression, intravenous drug use, a variety of chronic underlying diseases and prior surgical interventions. Nosocomial infections may originate from contaminated air ventilation systems or water pipes. Most common causative pathogen is Aspergillus fumigatus, followed by Aspergillus flavus and Aspergillus nidulans. A. niger, A. tubingensis and A. terreus are rare but stress the need of targeted and adapted antimycotic therapy. Diagnosis has to be pursued by means of MRI imaging techniques and tissue specimens. Multimodal treatment strategy is based on a combination of surgical debridement of necrotic bone and cartilage and systemically active antifungal treatment. Voriconazole combines satisfactory systemic antifungal effect, high oral bioavailability and good bone penetration. Development of fungicidal cement spacers still continues and in vitro data show promising results of bioactive cements. Purpose of this review of literature published between 2002 and 2013 was to provide up-to-date information on pathogenesis, diagnostic approach and treatment recommendations. Properly established treatment guidelines and prophylaxis for patients at risk are required as the high mortality rate continues to pose a future challenge.

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Pseudotumoral Cutaneous Aspergillosis in Chronic Granulomatous Disease, Report of a Pediatric Case

Cited by 9 publications

References 11 publications

Osteomyelitis caused by Aspergillus species: a review of 310 reported cases

Osteomyelitis caused by Aspergillus species: a review of 310 reported cases

Osseous Infections Caused by Aspergillus Species

Aspergillosis of bones and joints – a review from 2002 until today

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