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Bone and joint infection after traumatic implantation of Scedosporium prolificans treated with voriconazole and surgery
Author(s) -
Studahl M,
Backteman T,
Stålhammar F,
Chryssanthou E,
Petrini B
Publication year - 2003
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2003.tb00636.x
Subject(s) - voriconazole , medicine , discontinuation , osteomyelitis , arthrodesis , surgery , osteitis , rheumatoid arthritis , dermatology , pathology , antifungal , alternative medicine
Scedosporium prolificans is an environmental mould that may cause local infection in bone and joints after traumatic implantation, or generalized infection in immunocompromised patients. The fungus is highly drug resistant, both in vitro and in vivo. We present a case of osteomyelitis and arthritis caused by S. prolificans in a 9‐y‐old boy whose knee had been punctured by a hawthorn spike. Treatment with different drugs was difficult and arthrodesis was necessary. Concomitantly, voriconazole was given, and after three months bone biopsies were sterile despite a high in vitro MIC‐value of the fungus against voriconazole. Reversible skin depigmentation and fingernail oncholysis appeared toward the end of 17 months of voriconazole treatment. Twelve months after discontinuation of treatment, no signs of relapse were detected. Conclusion : Voriconazole may be a valuable adjunct to surgical treatment of bone and joint infection by Scedosporium prolificans.