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Histoplasmosis as the cause of a pathological fracture

N A Quraishi1, R N Davidson, N Steele

  • 1Department of Orthopaedics, Northwick Park Hospital, Harrow, Middlesex, England, UK.

The Journal of Bone and Joint Surgery. British Volume
|August 2, 2003
PubMed

Insights

An elderly man experienced a hip fracture due to Histoplasma capsulatum infection. Treatment involved surgery and antifungal medication, itraconazole, highlighting a rare presentation of this fungal disease.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Orthopedic Surgery

Background:

  • Histoplasma capsulatum is a fungus endemic to specific regions, typically causing pulmonary infections.
  • Disseminated histoplasmosis can affect various organs, but bone involvement leading to pathological fractures is rare.

Observation:

  • An 82-year-old male presented with a pathological hip fracture.
  • The fracture was confirmed to be caused by Histoplasma capsulatum var capsulatum infection.

Findings:

  • Surgical intervention with hemiarthroplasty was performed to address the fracture.
  • Systemic treatment with oral itraconazole was initiated for the fungal infection.

Implications:

  • This case underscores the importance of considering disseminated fungal infections, such as histoplasmosis, in the differential diagnosis of pathological fractures in elderly patients.
  • Successful management involved a combination of surgical repair and targeted antifungal therapy, demonstrating a viable treatment approach for this rare manifestation.

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