title: Costochondral involvement in systemic candidiasis in heroin addicts: clinical, scintigraphic, and histologic features in 26 patients.
abstract: We studied the clinical, scintigraphic, and histopathologic characteristics of 26 intravenous drug abusers with costochondral involvement secondary to systemic infection with Candida albicans. The clinical findings were of a mass appearing in the anterior region of the thorax. In general, signs of inflammation were absent. Histopathologic study of this costochondral mass in 12 patients showed perichondritis in 100% and myositis in 87%, with secondary involvement of cartilage in 43% and of bone in 75%. Results of bone scintigrams using 99mTc-methylene diphosphonate were positive in only 7 of 15 patients (47%), with a correlation between positive uptake and osteitis. Gallium scintigraphy findings were positive in 9 of 10 patients (90%). The greater sensitivity of 67Ga was probably because the invariably present pericartilaginous inflammatory mass was not always accompanied by secondary cartilage and bone involvement.
authors.affiliation: Infectious Diseases Unit, Hospital Clinic i Provincial, Barcelona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Miro
authors.forename: M A
authors.initials: MA
authors.lastname: Brancos
authors.forename: R
authors.initials: R
authors.lastname: Abello
authors.forename: F
authors.initials: F
authors.lastname: Lomena
authors.forename: J
authors.initials: J
authors.lastname: Bisbe
authors.forename: T
authors.initials: T
authors.lastname: Ribalta
authors.forename: J
authors.initials: J
authors.lastname: Rotes-Querol
mesh_terms: D000293:Adolescent; D000328:Adult; D002176:Candida albicans / Q000302:isolation & purification; D002177:Candidiasis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D002356:Cartilage / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D005260:Female; D003932:Heroin; D006801:Humans; D008297:Male; D012272:Ribs / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D019966:Substance-Related Disorders / Q000150:complications*; D013577:Syndrome; D014055:Tomography, Emission-Computed
chemical_list: D003932:Heroin