Universität zu Köln

Koehler, Philipp ORCID: 0000-0002-7386-7495, Tacke, Daniela and Cornely, Oliver A. (2016). Bone and joint infections by Mucorales, Scedosporium, Fusarium and even rarer fungi. Crit. Rev. Microbiol., 42 (1). S. 158 - 172. ABINGDON: TAYLOR & FRANCIS LTD. ISSN 1549-7828

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Abstract

Mucorales, Scedosporium and Fusarium species are rarely considered as cause for bone and joint infections. However, these moulds are emerging as important fungal pathogens in immunocompromised and immunocompetent patients. Typical pre-disposing host conditions are immunosuppression and diabetes. Most common causative pathogens are Mucorales followed by Scedosporium and Fusarium. Acremonium and Phialemonium species are rare but some case reports exist. MRI is the gold standard imaging technique. Tissue specimens obtained as aspirates, imaging guided biopsy or open surgery need mycological and histopathological work-up for genus and species identification. Multimodal treatment strategies combine surgical debridement, drainage of joints or abscesses, removal of infected prosthetic joints and systemic antifungals. The treatment of mucormycosis is polyene based and may be combined with either posaconazole or - in rare cases - caspofungin. As Scedosporium species are intrinsically resistant to polyenes and azoles show absence of in vitro activity, voriconazole plus synergistic treatment regimens become the therapeutic standard. In fusariosis, fungal susceptibility is virtually impossible to predict, so that combination treatment of voriconazole and lipid-based amphotericin B should be the first-line strategy while susceptibility results are pending. In the absence of randomized controlled trials, infections due to the above moulds should be registered, e.g. in the registries of the European Confederation of Medical Mycology (ECMM).

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:38-287655
DOI:	10.3109/1040841X.2014.910749
Journal or Publication Title:	Crit. Rev. Microbiol.
Volume:	42
Number:	1
Page Range:	S. 158 - 172
Date:	2016
Publisher:	TAYLOR & FRANCIS LTD
Place of Publication:	ABINGDON
ISSN:	1549-7828
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHRONIC GRANULOMATOUS-DISEASE; IMMUNOCOMPETENT MALE-PATIENT; RENAL-TRANSPLANT RECIPIENT; SKULL BASE OSTEOMYELITIS; OF-THE-LITERATURE; VERTEBRAL OSTEOMYELITIS; SEPTIC ARTHRITIS; PSEUDALLESCHERIA-APIOSPERMA; PROLIFICANS OSTEOMYELITIS; CLINICAL CHARACTERISTICS Multiple languages Microbiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/28765