Universität zu Köln

Koehler, Philipp ORCID: 0000-0002-7386-7495, Tacke, Daniela and Cornely, Oliver A. (2014). Aspergillosis of bones and joints - a review from 2002 until today. Mycoses, 57 (6). S. 323 - 336. HOBOKEN: WILEY. ISSN 1439-0507

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Abstract

Poor clinical outcome and complicated neurological complications illustrate the severity of bone and joint infections with Aspergillus species. Host predisposing conditions are immunosuppression, intravenous drug use, a variety of chronic underlying diseases and prior surgical interventions. Nosocomial infections may originate from contaminated air ventilation systems or water pipes. Most common causative pathogen is Aspergillus fumigatus, followed by Aspergillus flavus and Aspergillus nidulans. A. niger, A. tubingensis and A. terreus are rare but stress the need of targeted and adapted antimycotic therapy. Diagnosis has to be pursued by means of MRI imaging techniques and tissue specimens. Multimodal treatment strategy is based on a combination of surgical debridement of necrotic bone and cartilage and systemically active antifungal treatment. Voriconazole combines satisfactory systemic antifungal effect, high oral bioavailability and good bone penetration. Development of fungicidal cement spacers still continues and in vitro data show promising results of bioactive cements. Purpose of this review of literature published between 2002 and 2013 was to provide up-to-date information on pathogenesis, diagnostic approach and treatment recommendations. Properly established treatment guidelines and prophylaxis for patients at risk are required as the high mortality rate continues to pose a future challenge.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Koehler, Philipp UNSPECIFIED orcid.org/0000-0002-7386-7495 UNSPECIFIED Tacke, Daniela UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-437218
DOI:	10.1111/myc.12165
Journal or Publication Title:	Mycoses
Volume:	57
Number:	6
Page Range:	S. 323 - 336
Date:	2014
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1439-0507
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHRONIC GRANULOMATOUS-DISEASE; VERTEBRAL OSTEOMYELITIS; FUMIGATUS OSTEOMYELITIS; INVASIVE ASPERGILLOSIS; FUNGAL OSTEOMYELITIS; EPIDURAL ABSCESS; AMPHOTERICIN-B; PATIENT; VORICONAZOLE; INFECTION Multiple languages Dermatology; Mycology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43721