Osteomyelitis caused by Aspergillus species: A review of 310 reported cases

E. Gabrielli, A. W. Fothergill, L. Brescini, D. A. Sutton, E. Marchionni, E. Orsetti, S. Staffolani, P. Castelli, R. Gesuita, F. Barchiesi

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60 Scopus citations


Aspergillus osteomyelitis is a rare infection. We reviewed 310 individual cases reported in the literature from 1936 to 2013. The median age of patients was 43 years (range, 0-86 years), and 59% were males. Comorbidities associated with this infection included chronic granulomatous disease (19%), haematological malignancies (11%), transplantation (11%), diabetes (6%), pulmonary disease (4%), steroid therapy (4%), and human immunodeficiency virus infection (4%). Sites of infection included the spine (49%), base of the skull, paranasal sinuses and jaw (18%), ribs (9%), long bones (9%), sternum (5%), and chest wall (4%). The most common infecting species were Aspergillus fumigatus (55%), Aspergillus flavus (12%), and Aspergillus nidulans (7%). Sixty-two per cent of the individual cases were treated with a combination of an antifungal regimen and surgery. Amphotericin B was the antifungal drug most commonly used, followed by itraconazole and voriconazole. Several combination or sequential therapies were also used experimentally. The overall crude mortality rate was 25%.

Original languageEnglish (US)
Pages (from-to)559-565
Number of pages7
JournalClinical Microbiology and Infection
Issue number6
StatePublished - Jun 2014


  • Antifungals
  • Aspergillosis
  • Immunosuppressed patients
  • Osteomyelitis
  • Spondylodiscitis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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