Fungal bone infections
Abstract number: 10.1111/j.1198-743X.2004.902_s389.x
Fungal bone infections are rare. Worldwide ditributed infections such as those caused by Candida sp., Aspergillus sp. and Cryptococcus neoformans should be separated from those which are endemic (Histoplasma sp., Blastomyces dermatitidis, Coccidioides immitis, sporotrichosis and fungal mycetoma or dematiaceous fungi). Bone involvement can result from haematogenous dissemination or be secondary to skin infection followed by a contiguous extension. Evolution of the disease is most often subacute or chronic and radiological images are nonspecific. Diagnosis of fungal bone infection should be emphasized in some high-risk patients such as those who are immunocompromised or those who have travelled and stayed in endemic areas in the presence of subacute bone infection nonresponding to antibiotics. The diagnosis is obtained through direct examination or culture of a bone sample in association at least for some fungal diseases by the serum detection of fungal antigen or antibody. At the acute stage, the treatment is often based on the combination of surgery and antifungals, most often including amphotericin B or its lipid derivatives. New antifungals and particularly voriconazole recently gave very encouraging results in bone aspergillosis in our hands. In addition, caspofungin which has been shown to be active against biofilm producing Candida sp. strains could be promising for the treatment of fungal infected articular prosthetic devices. Systemic azoles are the long-term therapy of choice of such very difficult to treat infections."
|Session name:||XXIst ISTH Congress|
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