Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6617
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
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.
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.
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.