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Pathological rib fracture and soft tissue mass simulating malignancy--Cryptococcus, an unsuspected culprit
Rebecca M Harris1, Isaac E Stillman1, Jeffrey D Goldsmith1
1Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Diagnostic Microbiology and Infectious Disease
|January 14, 2015
Summary
Cryptococcal osteomyelitis can mimic soft tissue neoplasms, causing pathological rib fractures. This fungal infection should be considered in diagnosing bone fractures with soft tissue masses.
Area of Science:
- Infectious Diseases
- Orthopedics
- Radiology
Background:
- Pathological fractures require thorough differential diagnosis.
- Soft tissue masses accompanying bone lesions can complicate diagnosis.
- Initial presentation can be misleading, necessitating broader etiological consideration.
Observation:
- A patient presented with a pathological rib fracture and a soft tissue mass.
- The initial clinical suspicion was a soft tissue neoplasm.
- Further investigation explored infectious causes.
Findings:
- The pathological rib fracture and soft tissue mass were attributed to cryptococcal osteomyelitis.
- Cryptococcus infection was confirmed as the underlying etiology.
- This case highlights an unusual presentation of fungal osteomyelitis.
Implications:
- Cryptococcal osteomyelitis is a critical differential diagnosis for pathological fractures with soft tissue involvement.
- Clinicians should consider infectious etiologies, particularly fungal infections, in complex bone lesions.
- Early identification of cryptococcal osteomyelitis is crucial for appropriate treatment and patient outcomes.
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