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Cryptococcal Osteomyelitis of the Left Acetabulum: A Case Report
Changning Zhou1,2, Jing Zhang1, Yang Chen1,2
1Department of Radiology, The Fifth Affiliated Hospital of Zunyi Medical University, Zhufengdadao No.1439, Doumen District, Zhuhai 519110, Guangdong, China.
Background:
Cryptococcus, as a classical "opportunistic" fungal pathogen, is capable of disseminating an invasive infection in immunocompromised hosts. The primary sites of infection include the respiratory and central nervous systems, and skeletal infection was rarely reported. In this case, we describe a case of cryptococcal osteomyelitis involving the left side of the acetabulum in a Chinese patient with chronic hepatitis B.
Case Presentation:
We retrospectively reviewed the case of a female (with chronic hepatitis B) with left acetabulum pain and limited mobility, with fever occurring during the infection who presented to the Fifth Affiliated Hospital of Zunyi Medical University. Upon imaging, we found osteolytic bone destruction in the left acetabulum with inflammatory changes in the surrounding bone and soft tissue, accompanied by abscess formation. Following an 11-month of antifungal therapy, the clinical symptoms improved and the lesion area reduced in size. In addition, there was no sign of recurrence.
Conclusion:
Cryptococcus infections should be considered in the differential diagnosis of infectious osteolytic bone lesions, particularly when patients with immune insufficiency. Pathological examinations and fungal cultures are essential to provide a differential diagnosis.
Insights
This case report highlights a rare instance of cryptococcal osteomyelitis affecting the acetabulum in a patient with chronic hepatitis B. Early diagnosis and antifungal treatment led to symptom improvement and lesion reduction.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Skeletal Infections
Background:
- Cryptococcus is an opportunistic fungal pathogen primarily affecting immunocompromised individuals.
- Infections typically manifest in the respiratory and central nervous systems.
- Skeletal infections, such as osteomyelitis, are rarely reported.
Observation:
- A case of cryptococcal osteomyelitis involving the left acetabulum is presented in a Chinese patient with chronic hepatitis B.
- The patient presented with left acetabulum pain, limited mobility, and fever.
- Imaging revealed osteolytic bone destruction, surrounding inflammation, and abscess formation.
Findings:
- An 11-month course of antifungal therapy resulted in clinical symptom improvement.
- The size of the acetabular lesion was observed to decrease.
- No recurrence of infection was noted after treatment.
Implications:
- Cryptococcal infections should be considered in the differential diagnosis of infectious osteolytic bone lesions, especially in immunocompromised patients.
- Pathological examination and fungal cultures are crucial for accurate diagnosis.
- This case expands the understanding of Cryptococcus manifestations in skeletal sites.
