Successful Treatment of Saksenaea sp. Osteomyelitis by Conservative Surgery and Intradiaphyseal Incorporation of Amphotericin B Cement Beads

Antimicrob Agents Chemother. 2018 Dec 21;63(1):e01006-18. doi: 10.1128/AAC.01006-18. Print 2019 Jan.

Abstract

Osteoarticular mucormycosis cases are quite rare and challenging infections that are mostly due to direct inoculation during traumatic injury among immunocompetent patients. Classic management includes a combination of aggressive surgical debridement, which may lead to amputation, and long-term systemic liposomal amphotericin B therapy. This article describes the successful treatment of Saksenaea sp. osteomyelitis in a patient with diabetes mellitus, using a combination of systemic antifungal therapy and conservative surgery with insertion of amphotericin-impregnated cement beads.

Keywords: Mucorales; amphotericin B; antifungal agents; osteomyelitis.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B / administration & dosage
  • Amphotericin B / therapeutic use*
  • Antifungal Agents / therapeutic use*
  • Debridement
  • Diabetes Complications / microbiology
  • Diabetes Mellitus
  • Drug Carriers / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Mucorales / drug effects
  • Mucormycosis / drug therapy*
  • Mucormycosis / microbiology
  • Osteomyelitis / drug therapy*
  • Osteomyelitis / microbiology
  • Osteomyelitis / surgery

Substances

  • Antifungal Agents
  • Drug Carriers
  • liposomal amphotericin B
  • Amphotericin B