title: A rare case of cryptococcal infection of talus with pathological fracture that healed with medical management.
abstract: Skeletal involvement occurs in 5% to 10% of reported cases of disseminated cryptococcal infection. We are reporting a very rare presentation of cryptococcal infection of the talus with pathological fracture, which healed with medical management. Our patient had pain and swelling around the ankle associated with fever. Radiologically, he had a lytic lesion of the talus with fracture of the talar neck. Biopsy and cultures revealed cryptococcal infection. He was treated with surgical debridement combined with antifungal therapy, and the fracture healed well by 5 months. At the end of the 1-year follow-up, he had painless ankle movement and there was no evidence of recurrence. He was able to walk without support or limp, and he could wear normal footwear.
authors.affiliation: Department of Orthopaedics Unit 1, Christian Medical College, Vellore, Tamil Nadu, India. drgopi9596@gmail.com
authors.forename: G Gopisankar
authors.initials: GG
authors.lastname: Balaji
authors.forename: Alice Joan
authors.initials: AJ
authors.lastname: Mathuram
authors.forename: Justin
authors.initials: J
authors.lastname: Arockiaraj
authors.forename: George M
authors.initials: GM
authors.lastname: Varghese
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D003131:Combined Modality Therapy; D003453:Cryptococcosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D003646:Debridement / Q000379:methods*; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016469:Fungemia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011859:Radiography; D035583:Rare Diseases; D018570:Risk Assessment; D013628:Talus / Q000000981:diagnostic imaging / Q000293:injuries*; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents