Diagnosis of chronic osteomyelitis complicated with mycotic infection

Abstract

Introduction In the last decade, there has been an increase in the incidence rate of mycoses in patients after injuries and/or operations performed on limb segments and major joints. Mycoses are difficult to diagnose early because the mycotic flora may mimic the bacterial flora being present in the osteomyelitic nidus and primarily identified in the wound exudate. Objective To develop diagnostic criteria for osteomyelitis complicated with mycotic infection. Methods We performed a retrospective study of 28 patients (17 males and 11 females) aged 21 to 76 years (49 ± 16 years) who were treated for purulent inflammatory lesions of bones and/or joints at the clinic of osteology infection between 2000 and 2018. Results Mycotic infection was pathomorphologically detected in the osteomyelitis nidus of all patients. Patients were treated according to the established protocol including radical sequestrectomy, diagnostic biopsy and postoperative administration of antimicrobial and antifungal therapy. Discussion The study allowed identification of several diagnostic criteria for osteomyelitis complicated by mycotic infection. Pathomorphological examination of surgical specimen from purulent inflammatory nidus was shown to be the keystone in diagnosis of osteomyelitis complicated with mycoses.