Disseminated Cryptococcal Osteomyelitis to the Hand in an Immunosuppressed Lymphoma Patient

J Hand Surg Am. 2018 Mar;43(3):291.e1-291.e6. doi: 10.1016/j.jhsa.2017.07.013. Epub 2017 Aug 26.

Abstract

Fungal osteomyelitis of the hand is rare with limited evidence-based literature to guide diagnosis and management. We report a case of disseminated cryptococcal osteomyelitis in the middle phalanx from a pulmonary fungal infection in a patient with a history of lymphoplasmacytic lymphoma. Although rare, cryptococcosis should be considered in the differential diagnosis of aggressive lytic lesions with bone pain and associated large soft tissue masses, especially in the immunosuppressed host.

Keywords: Cryptococcosis; fungal; immunosuppression; osteomyelitis; phalanx.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use
  • Cryptococcosis / diagnosis*
  • Cryptococcosis / drug therapy
  • Hand / microbiology*
  • Humans
  • Immunocompromised Host
  • Itraconazole / therapeutic use
  • Male
  • Middle Aged
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / microbiology*
  • Osteomyelitis / diagnostic imaging
  • Osteomyelitis / drug therapy
  • Osteomyelitis / microbiology*
  • Waldenstrom Macroglobulinemia

Substances

  • Antifungal Agents
  • Itraconazole