title: Fungal osteomyelitis and septic arthritis.
abstract: Management of fungal osteomyelitis and fungal septic arthritis is challenging, especially in the setting of immunodeficiency and conditions that require immunosuppression. Because fungal osteomyelitis and fungal septic arthritis are rare conditions, study of their pathophysiology and treatment has been limited. In the literature, evidence-based treatment is lacking and, historically, outcomes have been poor. The most common offending organisms are Candida and Aspergillus, which are widely distributed in humans and soil. However, some fungal pathogens, such as Histoplasma, Blastomyces, Coccidioides, Cryptococcus, and Sporothrix, have more focal areas of endemicity. Fungal bone and joint infections result from direct inoculation, contiguous infection spread, or hematogenous seeding of organisms. These infections may be difficult to diagnose and eradicate, especially in the setting of total joint arthroplasty. Although there is no clear consensus on treatment, guidelines are available for management of many of these pathogens.
authors.affiliation: From the Division of Orthopaedic Trauma, Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Jason T
authors.initials: JT
authors.lastname: Bariteau
authors.affiliation: From the Division of Orthopaedic Trauma, Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Waryasz
authors.affiliation: From the Division of Orthopaedic Trauma, Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Matthew
authors.initials: M
authors.lastname: McDonnell
authors.affiliation: From the Division of Orthopaedic Trauma, Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Staci A
authors.initials: SA
authors.lastname: Fischer
authors.affiliation: From the Division of Orthopaedic Trauma, Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Roman A
authors.initials: RA
authors.lastname: Hayda
authors.affiliation: From the Division of Orthopaedic Trauma, Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Born
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D003952:Diagnostic Imaging; D006801:Humans; D009181:Mycoses / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D010019:Osteomyelitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents