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罕见的孤立性趾部曲霉菌骨髓炎病例:病例介绍与治疗

Rare case of Isolated Aspergillus Osteomyelitis of Toe: Presentation and Management.

作者信息

Pattanashetty O B, B B Dayanand, Bhavi Shushrut B, Bami Monish

机构信息

Department of Orthopedics, Shri B M Patil Medical college, B.L.D.E University, Bijapur, India.

出版信息

J Orthop Case Rep. 2013 Apr-Jun;3(2):29-31. doi: 10.13107/jocr.2250-0685.098.

Abstract

INTRODUCTION

Fungal osteomyelitis is an uncommon diseases and generally present in an indolent fashion. Isolated bone affection due to fungi are rare and we present one such case with fungal osteomyelitis of terminal phalanx of second toe.

CASE REPORT

We present a rare case of fungal osteomyelitis of right second toe in a 30 year old Indian female who presented with swelling of 8 months duration. Diagnosis was based on the histo-pathological report and culture showing Aspergillus growth. The patient was treated with surgical debridement and amphotericin-B was given for 6 weeks after debridement. There was no recurrence one year post surgery.

CONCLUSION

Isolated Aspergillus osteomyelitis of the bone are very rare and mostly seen in immunocompromised patients and larger bones like spine, femur and tibia. Treatment with wound debridement and subsequently followed up with a course of Amphotericin-B for 6 weeks provided good results. There was no recurrence noted at 1 year follow up. Fungi should be kept in mind for differential diagnosis of osteomyelitis and culture should be appropriately ordered.

摘要

引言

真菌性骨髓炎是一种罕见疾病,通常呈隐匿性发病。由真菌引起的孤立性骨感染很少见,我们在此报告一例第二趾末节指骨真菌性骨髓炎病例。

病例报告

我们报告一例罕见的30岁印度女性右第二趾真菌性骨髓炎病例,患者有长达8个月的肿胀症状。诊断基于组织病理学报告及培养显示曲霉菌生长。患者接受了手术清创治疗,并在清创后给予两性霉素B治疗6周。术后一年无复发。

结论

孤立性骨曲霉菌骨髓炎非常罕见,多见于免疫功能低下患者以及脊柱、股骨和胫骨等较大骨骼。伤口清创治疗,随后给予一个疗程的两性霉素B治疗6周,效果良好。随访1年未见复发。在骨髓炎的鉴别诊断中应考虑真菌因素,并应适当安排培养检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/098c/4719239/753ef3e1a700/JOCR-3-29-g001.jpg

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