Ma JL, Liao L, Wan T, Yang FC. Isolated cryptococcal osteomyelitis of the ulna in an immunocompetent patient: A case report. World J Clin Cases 2022; 10(19): 6617-6625 [PMID: 35979300 DOI: 10.12998/wjcc.v10.i19.6617]
Corresponding Author of This Article
Fu-Chun Yang, MD, PhD, Chief Physician, Professor, Department of Orthopedic Trauma and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning 530021, Guangxi Province, China. yangfuch89@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 6, 2022; 10(19): 6617-6625 Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6617
Isolated cryptococcal osteomyelitis of the ulna in an immunocompetent patient: A case report
Jing-Long Ma, Liang Liao, Tao Wan, Fu-Chun Yang
Jing-Long Ma, Liang Liao, Tao Wan, Fu-Chun Yang, Department of Orthopedic Trauma and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Province, China
Jing-Long Ma, Liang Liao, Tao Wan, Fu-Chun Yang, Guangxi Key Laboratory of Regenerative Medicine, Department of Orthopedics, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Province, China
Author contributions: Ma JL collected the clinical data and drafted the manuscript; Liao L interpreted important clinical findings; Wan T assisted in analysis of the clinical data; Yang FC designed and revised the manuscript; All authors have read and approve the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient prior to publication of this case report, and the patient’s identity has been kept confidential.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fu-Chun Yang, MD, PhD, Chief Physician, Professor, Department of Orthopedic Trauma and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning 530021, Guangxi Province, China. yangfuch89@163.com
Received: December 20, 2021 Peer-review started: December 20, 2021 First decision: January 25, 2022 Revised: February 9, 2022 Accepted: May 5, 2022 Article in press: May 5, 2022 Published online: July 6, 2022
Abstract
BACKGROUND
Cryptococcal osteomyelitis is a bone infection caused by cryptococcus. As an opportunistic infection, bone cryptococcosis usually occurs in patients with immunodeficiency diseases or in those undergoing immunosuppressive therapy and often displays characteristics of disseminated disease. Isolated cryptococcal osteomyelitis is extremely unusual in immunocompetent person. The pathogenic fungus often invades vertebrae, femur, tibia, rib, clavicle, pelvis, and humerus, but the ulna is a rare target.
CASE SUMMARY
A 79-year-old woman complaining of chronic pain, skin ulceration and a sinus on her right forearm was admitted, and soon after was diagnosed with cryptococcal osteomyelitis in the right ulna. Unexpectedly, she was also found to have apparently normal immunity. After treatment with antifungal therapy combined with surgery debridement, the patient’s osteomyelitis healed with a satisfactory outcome.
CONCLUSION
Although rare, cryptococcal osteomyelitis should be considered in the differential diagnosis of osteolytic lesions even in immunocompetent patients, and good outcomes can be expected if early definitive diagnosis and etiological treatment are established.
Core Tip: Cryptococcal osteomyelitis often occurs in immunocompromised patients and usually involves vetebrae, femur, tibia, rib, clavicle, pelvis. Here we report a case of isolated cryptococcal osteomyelitis in the ulna in an immunocompetent elderly woman, which is extremely rare. She was timely diagnosed and treated, and achieved good clinical outcome. Although rare, cryptococcal osteomyelitis should be considered in the differential diagnosis of osteolytic lesions even in immunocompetent patients.
