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J Am Acad Orthop Surg. 2014 Jun;22(6):390-401. doi: 10.5435/JAAOS-22-06-390.

Fungal osteomyelitis and septic arthritis.

Author information

1
From the Division of Orthopaedic Trauma, Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI.

Abstract

Management of fungal osteomyelitis and fungal septic arthritis is challenging, especially in the setting of immunodeficiency and conditions that require immunosuppression. Because fungal osteomyelitis and fungal septic arthritis are rare conditions, study of their pathophysiology and treatment has been limited. In the literature, evidence-based treatment is lacking and, historically, outcomes have been poor. The most common offending organisms are Candida and Aspergillus, which are widely distributed in humans and soil. However, some fungal pathogens, such as Histoplasma, Blastomyces, Coccidioides, Cryptococcus, and Sporothrix, have more focal areas of endemicity. Fungal bone and joint infections result from direct inoculation, contiguous infection spread, or hematogenous seeding of organisms. These infections may be difficult to diagnose and eradicate, especially in the setting of total joint arthroplasty. Although there is no clear consensus on treatment, guidelines are available for management of many of these pathogens.

PMID:
24860135
DOI:
10.5435/JAAOS-22-06-390
[Indexed for MEDLINE]

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