Risk Factors, Clinical Characteristics, Management, and Outcomes of Musculoskeletal Fungal Infection at Thailand’s Largest National Tertiary Referral Center
Issued Date
2022-02-01
Resource Type
eISSN
2309608X
Scopus ID
2-s2.0-85125060356
Journal Title
Journal of Fungi
Volume
8
Issue
2
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Fungi Vol.8 No.2 (2022)
Suggested Citation
Chokevittaya P., Chayakulkeeree M., Katchamart W. Risk Factors, Clinical Characteristics, Management, and Outcomes of Musculoskeletal Fungal Infection at Thailand’s Largest National Tertiary Referral Center. Journal of Fungi Vol.8 No.2 (2022). doi:10.3390/jof8020191 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/83325
Title
Risk Factors, Clinical Characteristics, Management, and Outcomes of Musculoskeletal Fungal Infection at Thailand’s Largest National Tertiary Referral Center
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
To investigate the risk factors, clinical characteristics, management, and outcomes of mus-culoskeletal fungal infection in Thai patients, patients aged ≥18 years definitively diagnosed with musculoskeletal fungal infection by culture and/or histopathology at Siriraj Hospital (Bangkok, Thai-land) during 2002–2020 were retrospectively enrolled. Twenty-eight patients (median age: 58.5 years [range: 22–81], 57.1% male) with fungal osteomyelitis (n = 22), septic arthritis (n = 1), or fungal osteomyelitis with septic arthritis (n = 5) were included. Immunocompromised status was common (82%). Most patients had de novo infection from hematogenous spreading that usually presented at a single, non-contiguous site. The median symptom duration prior to diagnosis was 2 months. The tibia and knee were the most common site of osteomyelitis (30%) and septic arthritis (72%), respectively. The most common pathogens were Talaromyces marneffei and Cryptococcus neoformans. Organism identification from tissues at the affected sites was required in all cases. Most patients (82%) required combination surgery and systemic antifungal therapy. Among those with complete follow-up (23/28), 61% and 39% had complete and partial responses, respectively. Musculoskeletal fungal infection is an uncommon disease with insidious onset and non-specific manifestations that requires pathogen identification via tissue cultures and histopathologic studies. Combination surgery and systemic antifungal therapy yielded generally favorable outcomes.