Isolated cryptococcal osteomyelitis as a differential diagnosis of hallux valgus
Keywords:
Cryptococcus neoformans, Curettage and Cementation, Hallux valgus, Orthopaedics, Multiple Sclerosis.Abstract
Cryptococcus neoformans is a ubiquitous encapsulated yeast that causes infection as an opportunistic agent primarily in immunocompromised patients, and more rarely, in immunocompetent subjects. Cryptococcal bone involvement can occur in the context of a disseminated infection or as single localization due to, for example, direct inoculation through traumatic injuries or during surgery and minor procedures. Cryptococcosis must be, therefore, included in the differential diagnosis of osteolyic lesions. Bone biopsy should be performed to confirm the diagnosis of cryptococcal infection and to initiate an early course of therapy. Hereby, we present a case of an extrapulmonary isolated cryptococcal osteomyelitis in a female affected with multiple sclerosis (MS), firstly evaluated for hallux valgus, and later diagnosed with a cryptococcal infection by performing a bone biopsy. As there are no codified guidelines on treatment in cryptococcal osteomyelitis we have chosen a combined approach with medical and surgical management with success at 1 year follow-up.
References
Zirngibl B, Grifka J, Baier C, Götz J. Hallux valgus. Orthopade. 2017 Mar 1;46(3):283–96. DOI: 10.1007/s00132-017-3397-3
Medaris LA, Ponce B, Hyde Z, et al. Cryptococcal osteomyelitis: a report of 5 cases and a review of the recent literature. Mycoses. 2016 Jun;59(6):334–42. DOI: 10.1111/myc.12476
Bariteau JT, Waryasz GR, McDonnell M, Fischer SA, Hayda CRA, Born CT. Fungal Osteomyelitis and Septic Arthritis. J Am Acad Orthop Surg. 2014 Jun;22(6):390–401. DOI: 10.5435/JAAOS-22-06-390
Dumenigo A, Sen M. Cryptococcal Osteomyelitis in an Immunocompetent Patient. Cureus. 2022 Jan 10. DOI: 10. 10.7759/cureus.21074
Maziarz EK, Perfect JR. Cryptococcosis. Infect Dis Clin North Am. 2016 Mar;30(1):179–206. DOI: 10.1016/j.idc.2015.10.006
Zhou H-X, Lu L, Chu T, et al. Skeletal cryptococcosis from 1977 to 2013. Front Microbiol. 2015 Jan 14;5. DOI: 10.3389/fmicb.2014.00740
Yeung CM, Fabbri N. Disseminated Cryptococcus infection presenting as lytic skeletal lesions suggesting bony metastatic disease. Skeletal Radiol. 2023 Sep 25. DOI: 10.1007/s00256-023-04442-0
Sethi S. Cryptococcal osteomyelitis in the ribs. J Glob Infect Dis. 2010;2(1):63. DOI: 10.4103/0974-777X.59253
Perfect JR, Dismukes WE, Dromer F, et al. Clinical Practice Guidelines for the Management of Cryptococcal Disease: 2010 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2010 Feb 1;50(3):291–322. DOI: 10.1086/649858
Downloads
Published
Issue
Section
License
Copyright (c) 2024 sahar toumie
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
