Document Detail

Coccidioides immitis osteomyelitis: a case series review.
MedLine Citation:
PMID:  12195909     Owner:  NLM     Status:  MEDLINE    
A retrospective chart review and telephone follow-up was conducted on patients who were treated for disseminated coccidioidomycosis involving bones or joints at the Naval Medical Center, San Diego, California from 1993-1999. Thirteen patients were identified, with average follow-up of 36 months. Six patients underwent surgical debridement and systemic medical therapy, and seven patients were treated medically only. All patients improved symptomatically with decreasing complement fixation titers at last follow-up. Five of the six patients treated with combined therapy are currently quiescent. Of those treated medically, four patients are quiescent; three were lost to follow-up. Coccidioidomycosis osteomyelitis remains a rare but difficult disease to treat, with a lifelong risk of recurrence. A combined medical and surgical approach has been shown to be effective, but medical therapy alone with intravenous amphotericin B followed by suppressive azole therapy may be effective in selected patients.
Keith Holley; Michael Muldoon; Sybil Tasker
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Orthopedics     Volume:  25     ISSN:  0147-7447     ISO Abbreviation:  Orthopedics     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-27     Completed Date:  2003-02-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  827-31, 831-2     Citation Subset:  IM    
Department of Orthopedic Surgery, Naval Medical Center, 34800 Bob Wilson Dr, Ste 5, San Diego, CA 92134-1005, USA.
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MeSH Terms
Amphotericin B / therapeutic use
Coccidioides* / isolation & purification
Coccidioidomycosis / diagnosis*,  therapy*
Debridement / methods
Itraconazole / therapeutic use
Magnetic Resonance Imaging
Middle Aged
Osteomyelitis / diagnosis*,  microbiology,  therapy*
Retrospective Studies
Treatment Outcome
Reg. No./Substance:
1397-89-3/Amphotericin B; 84625-61-6/Itraconazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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