Koutserimpas Christos, Chamakioti Ifigeneia, Naoum Symeon, Raptis Konstantinos, Alpantaki Kalliopi, Samonis George
Department of Orthopaedics and Traumatology, "251" Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece.
Department of Orthopaedics and Traumatology, "Venizeleion" General Hospital of Heraklion, 71409 Heraklion, Greece.
Diagnostics (Basel). 2021 Dec 11;11(12):2335. doi: 10.3390/diagnostics11122335.
Septic arthritis due to spp. represents a rare, but severe disease. Nevertheless, clear guidelines regarding most effective medical treatment have not yet been established. The present study is a literature review of all reported cases of fungal septic arthritis due to spp, in order to clarify epidemiology, as well as the medical and operative management and their outcome.
A meticulous review of all published septic arthritis infections due to has been conducted. Information regarding demographics, causative fungus, antifungal treatment (AFT), surgical intervention, as well as the infection's outcome were recorded and evaluated.
A total of 30 spp. strains from 29 hosts have been studied. The patients' mean age was 45.8 years. The most commonly affected joint was the knee (45.7%), while the predominant symptom was joint pain (62%). Most patients were immunocompromised (72.4%). Diagnosis was established through cultures and/or histopathology. was the most common responsible fungi (63.3%), followed by (16.6%) and (10%). Regarding AFT, the preferred agent proved to be Amphotericin B (14 cases; 48.3%), followed by voriconazole (11; 37.9%), while the mean AFT duration was 5.6 months. In most cases surgical treatment was also performed (in 4 cases no surgery was reported). Treatment was effective in 20 cases (69%).
Septic arthritis caused by spp. represents a severe clinical entity. It seems that, with the available data, prolonged AFT along with surgical intervention is the preferred management of this infection, while identification of the responsible fungus is of utmost importance.
由 spp. 引起的化脓性关节炎是一种罕见但严重的疾病。然而，关于最有效药物治疗的明确指南尚未建立。本研究是对所有已报道的由 spp. 引起的真菌性化脓性关节炎病例的文献综述，以阐明其流行病学、药物和手术治疗及其结果。
对所有已发表的由 引起的化脓性关节炎感染进行了细致回顾。记录并评估了有关人口统计学、致病真菌、抗真菌治疗（AFT）、手术干预以及感染结果的信息。
共研究了来自29例宿主的30株 spp. 菌株。患者的平均年龄为45.8岁。最常受累的关节是膝关节（45.7%），而主要症状是关节疼痛（62%）。大多数患者免疫功能低下（72.4%）。通过培养和/或组织病理学确诊。 是最常见的致病真菌（63.3%），其次是 （16.6%）和 （10%）。关于抗真菌治疗，首选药物是两性霉素B（14例；48.3%），其次是伏立康唑（11例；37.9%），抗真菌治疗的平均持续时间为5.6个月。大多数情况下也进行了手术治疗（4例未报告手术情况）。20例（69%）治疗有效。
由 spp. 引起的化脓性关节炎是一种严重的临床病症。根据现有数据，似乎延长抗真菌治疗并结合手术干预是这种感染的首选治疗方法，而确定致病真菌至关重要。
