Kohli Rakhi, Hadley Susan
Tufts University School of Medicine, Division of Geographic Medicine and Infectious Disease, Tufts-New England Medical Center, Boston, MA 02111, USA.
Infect Dis Clin North Am. 2005 Dec;19(4):831-51. doi: 10.1016/j.idc.2005.08.004.
Fungal arthritis and osteomyelitis are uncommon diseases and generally present in an indolent fashion. The incidence of fungal bone and joint dis-ease is increasing with an increase in the prevalence of factors predisposing to invasive fungal disease, such as the use of central venous catheters, broad spectrum antibiotics, immunosuppression, and abdominal surgery. Definitive diagnosis relies on bone or synovial culture or biopsy. Successful management has traditionally consisted of amphotericin B in combination with surgical debridement. Given the rarity of this disease, treatment is not well defined, but reports of success with the use of azole antifungal agents, including itraconazole, fluconazole, voriconazole, and posaconazole, are promising.
真菌性关节炎和骨髓炎是罕见疾病，通常呈隐匿性发病。随着侵袭性真菌病易感因素（如中心静脉导管的使用、广谱抗生素、免疫抑制和腹部手术）患病率的增加，真菌性骨与关节疾病的发病率也在上升。明确诊断依赖于骨或滑膜培养或活检。传统上，成功的治疗方法是两性霉素B联合手术清创。鉴于这种疾病的罕见性，治疗方法尚无明确界定，但使用唑类抗真菌药物（包括伊曲康唑、氟康唑、伏立康唑和泊沙康唑）取得成功的报道很有前景。
