Musculoskeletal fungal infections

Area of Science:

• Mycology
• Infectious Diseases
• Musculoskeletal Radiology

Background:

• Fungal infections of the musculoskeletal system are infrequent but serious conditions.
• These infections disproportionately affect immunocompromised patients, including those with acquired immunodeficiency syndrome (AIDS).
• Patients with a history of travel to fungal endemic regions are also at higher risk.

Purpose of the Study:

• To highlight the uncommon nature of fungal musculoskeletal infections.
• To describe the typical clinical presentations and diagnostic challenges.
• To emphasize the role of radiologists and the necessity of definitive diagnostic methods.

Main Methods:

• Review of clinical presentations and imaging findings associated with fungal musculoskeletal infections.
• Discussion of patient populations at increased risk.
• Emphasis on diagnostic clues and necessary laboratory confirmations.

Main Results:

• Fungal musculoskeletal infections often manifest as multifocal chronic osteomyelitis or chronic mono- or polyarthritis.
• These presentations can mimic osteoarticular tuberculosis, posing a diagnostic challenge.
• The presence of overlying skin sinuses is a significant clinical indicator.

Conclusions:

• Accurate diagnosis of fungal musculoskeletal infections relies on a combination of clinical suspicion and diagnostic procedures.
• Radiologists play a crucial role in suggesting the diagnosis with thorough clinical history evaluation.
• Biopsy and fungal culture are typically essential for confirming the diagnosis and guiding treatment.