title: Cryptococcal osteomyelitis of the scapula and rib in an immunocompetent patient.
abstract: Cryptococcal osteomyelitis is extremely rare and almost always occurs in immunocompromised patients. We describe a case of osteomyelitis due to Cryptococcus neoformans involving both scapula and rib in an immunocompetent and previously healthy patient. The patient received treatment with amphotericin B deoxycholate and flucytosine for 4 weeks, followed by oral fluconazole 400 mg per day for 8 weeks and 200 mg per day for 9 months. The 12-month course of antifungal therapy resulted in complete clinical recovery and undetectable serum cryptococcal antigen. Cryptococcal osteomyelitis should be suspected in any immunocompetent patient with osteolytic lesions on radiological images.
authors.affiliation: Department of Infectious Diseases, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, PR China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Yong-Sheng
authors.initials: YS
authors.lastname: Yu
authors.forename: Zheng-Hao
authors.initials: ZH
authors.lastname: Tang
authors.forename: Guo-Qing
authors.initials: GQ
authors.lastname: Zang
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D003453:Cryptococcosis / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology; D003455:Cryptococcus neoformans / Q000302:isolation & purification*; D003840:Deoxycholic Acid / Q000008:administration & dosage; D004338:Drug Combinations; D005260:Female; D005437:Flucytosine / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology; D012272:Ribs / Q000382:microbiology* / Q000473:pathology; D012540:Scapula / Q000382:microbiology* / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D004338:Drug Combinations; D003840:Deoxycholic Acid; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination; D005437:Flucytosine