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Deep Fungal Infections of the Upper Extremity - A Review
Konstantinos Ditsios1, Triantafyllos Katsimentzas1, Charalampos Pitsilos1
12nd Academic Department of Orthopaedic Surgery School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital of Thessaloniki "G. Gennimatas", Greece.
Abstract:
Deep fungal infections are rare in the upper extremity. Vessel and nerve infection, synovitis, tenosynovitis, myofasciitis, arthritis and osteomyelitis have been discovered in literature. Treatment in most cases includes surgical procedure and antifungal agent use. Amputation is the final, most devastating for patient's functionality, solution. Intravenous antifungal drugs, frequently followed by oral administration, are important ancillary agents both for the initial treatment and the prevention of recurrence. We therefore performed a review of the current literature, in order to assemble the dispersed results of different studies and clarify the various aspects of upper extremity fungal infections.
Insights
Deep fungal infections affecting the upper extremity are uncommon but serious. This review synthesizes current literature on diagnosis and treatment, emphasizing antifungal agents and surgical interventions to prevent severe outcomes like amputation.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Orthopedic Surgery
Background:
- Deep fungal infections of the upper extremity are rare but can lead to severe morbidity.
- Literature documents various manifestations including vessel and nerve involvement, synovitis, tenosynovitis, myofasciitis, arthritis, and osteomyelitis.
- Current treatment paradigms often involve surgical intervention and antifungal therapy.
Purpose of the Study:
- To review and consolidate existing literature on deep fungal infections of the upper extremity.
- To clarify the diverse clinical presentations and diagnostic challenges.
- To synthesize current treatment strategies and outcomes, including the role of antifungal agents and surgery.
Main Methods:
- Comprehensive literature search of studies related to upper extremity fungal infections.
- Analysis of reported cases focusing on clinical presentation, causative agents, and treatment modalities.
- Synthesis of findings to provide an overview of the current knowledge.
Main Results:
- Fungal infections in the upper extremity present with a range of musculoskeletal and vascular complications.
- Surgical debridement and antifungal therapy are primary treatment approaches.
- Amputation remains a potential, albeit drastic, outcome in severe or refractory cases.
Conclusions:
- Early diagnosis and appropriate management, combining surgical and antifungal treatments, are crucial for limb salvage.
- Further research is needed to optimize treatment protocols and improve patient outcomes.
- Understanding the spectrum of deep fungal infections in the upper extremity is vital for clinicians.
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