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Native Joint Infections by Aspergillus Species

Background: Septic arthritis due to Aspergillus spp. represents a rare, but severe disease. Nevertheless, clear guidelines regarding most effective medical treatment have not yet been established. The present study is a literature review of all reported cases of fungal septic arthritis due to Asperg...

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Autores principales: Koutserimpas, Christos, Chamakioti, Ifigeneia, Naoum, Symeon, Raptis, Konstantinos, Alpantaki, Kalliopi, Samonis, George
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700121/
https://www.ncbi.nlm.nih.gov/pubmed/34943572
http://dx.doi.org/10.3390/diagnostics11122335
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author Koutserimpas, Christos
Chamakioti, Ifigeneia
Naoum, Symeon
Raptis, Konstantinos
Alpantaki, Kalliopi
Samonis, George
author_facet Koutserimpas, Christos
Chamakioti, Ifigeneia
Naoum, Symeon
Raptis, Konstantinos
Alpantaki, Kalliopi
Samonis, George
author_sort Koutserimpas, Christos
collection PubMed
description Background: Septic arthritis due to Aspergillus spp. represents a rare, but severe disease. Nevertheless, clear guidelines regarding most effective medical treatment have not yet been established. The present study is a literature review of all reported cases of fungal septic arthritis due to Aspergillus spp, in order to clarify epidemiology, as well as the medical and operative management and their outcome. Methods: A meticulous review of all published septic arthritis infections due to Aspergillus has been conducted. Information regarding demographics, causative fungus, antifungal treatment (AFT), surgical intervention, as well as the infection’s outcome were recorded and evaluated. Results: A total of 30 Aspergillus spp. strains from 29 hosts have been studied. The patients’ mean age was 45.8 years. The most commonly affected joint was the knee (45.7%), while the predominant symptom was joint pain (62%). Most patients were immunocompromised (72.4%). Diagnosis was established through cultures and/or histopathology. Aspergillus fumigatus was the most common responsible fungi (63.3%), followed by A. flavus (16.6%) and A. terreus (10%). Regarding AFT, the preferred agent proved to be Amphotericin B (14 cases; 48.3%), followed by voriconazole (11; 37.9%), while the mean AFT duration was 5.6 months. In most cases surgical treatment was also performed (in 4 cases no surgery was reported). Treatment was effective in 20 cases (69%). Conclusions: Septic arthritis caused by Aspergillus spp. represents a severe clinical entity. It seems that, with the available data, prolonged AFT along with surgical intervention is the preferred management of this infection, while identification of the responsible fungus is of utmost importance.
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spelling pubmed-87001212021-12-24 Native Joint Infections by Aspergillus Species Koutserimpas, Christos Chamakioti, Ifigeneia Naoum, Symeon Raptis, Konstantinos Alpantaki, Kalliopi Samonis, George Diagnostics (Basel) Review Background: Septic arthritis due to Aspergillus spp. represents a rare, but severe disease. Nevertheless, clear guidelines regarding most effective medical treatment have not yet been established. The present study is a literature review of all reported cases of fungal septic arthritis due to Aspergillus spp, in order to clarify epidemiology, as well as the medical and operative management and their outcome. Methods: A meticulous review of all published septic arthritis infections due to Aspergillus has been conducted. Information regarding demographics, causative fungus, antifungal treatment (AFT), surgical intervention, as well as the infection’s outcome were recorded and evaluated. Results: A total of 30 Aspergillus spp. strains from 29 hosts have been studied. The patients’ mean age was 45.8 years. The most commonly affected joint was the knee (45.7%), while the predominant symptom was joint pain (62%). Most patients were immunocompromised (72.4%). Diagnosis was established through cultures and/or histopathology. Aspergillus fumigatus was the most common responsible fungi (63.3%), followed by A. flavus (16.6%) and A. terreus (10%). Regarding AFT, the preferred agent proved to be Amphotericin B (14 cases; 48.3%), followed by voriconazole (11; 37.9%), while the mean AFT duration was 5.6 months. In most cases surgical treatment was also performed (in 4 cases no surgery was reported). Treatment was effective in 20 cases (69%). Conclusions: Septic arthritis caused by Aspergillus spp. represents a severe clinical entity. It seems that, with the available data, prolonged AFT along with surgical intervention is the preferred management of this infection, while identification of the responsible fungus is of utmost importance. MDPI 2021-12-11 /pmc/articles/PMC8700121/ /pubmed/34943572 http://dx.doi.org/10.3390/diagnostics11122335 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Koutserimpas, Christos
Chamakioti, Ifigeneia
Naoum, Symeon
Raptis, Konstantinos
Alpantaki, Kalliopi
Samonis, George
Native Joint Infections by Aspergillus Species
title Native Joint Infections by Aspergillus Species
title_full Native Joint Infections by Aspergillus Species
title_fullStr Native Joint Infections by Aspergillus Species
title_full_unstemmed Native Joint Infections by Aspergillus Species
title_short Native Joint Infections by Aspergillus Species
title_sort native joint infections by aspergillus species
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700121/
https://www.ncbi.nlm.nih.gov/pubmed/34943572
http://dx.doi.org/10.3390/diagnostics11122335
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