Yingling John Michael, Sun Li, Yoon Richard, Liporace Frank
Division of Orthopaedic Trauma & Adult Reconstruction, Department of Orthopaedic Surgery, Jersey City Medical Center - RWJBarnabas Health, Jersey City, NJ 07302 USA.
Patient Saf Surg. 2017 Dec 21;11:31. doi: 10.1186/s13037-017-0146-9. eCollection 2017.
is a rare opportunistic pathogen that can be found in immunosuppressed patients. There are seldom-reported cases of fungal osteomyelitis surrounding orthopedic implants.
This is a case of chronic osteomyelitis in an immunocompromised patient with a prior open reduction and internal fixation for a closed bimalleolar ankle fracture that went on to neglected wound complications. The patient underwent series of treatments including removal of hardware, serial irrigation and debridements, negative pressure wound therapy, and intravenous antifungal therapy. Our case illustrates the possibility of this rare pathogen involved in orthopedic surgery particularly in immunocompromised hosts.
Fungal and atypical pathogens should always be considered in such patients or if another diagnosis is not clear. Protracted time to culture specimens should be considered for at least four weeks in such situations. This article outlines a review of the literature and treatment algorithm to guide physicians when managing patients with this rare infection.
是一种罕见的机会性病原体，可在免疫抑制患者中发现。关于骨科植入物周围真菌性骨髓炎的报道病例很少。
这是一例免疫功能低下患者的慢性骨髓炎病例，该患者此前因闭合性双踝骨折接受了切开复位内固定术，但随后出现了被忽视的伤口并发症。患者接受了一系列治疗，包括取出内固定物、多次冲洗和清创、负压伤口治疗以及静脉抗真菌治疗。我们的病例说明了这种罕见病原体参与骨科手术的可能性，尤其是在免疫功能低下的宿主中。
对于此类患者或诊断不明确时，应始终考虑真菌和非典型病原体。在这种情况下，应考虑将培养标本的时间延长至少四周。本文概述了文献综述和治疗算法，以指导医生处理这种罕见感染的患者。
