Case study: Treating Fusarium osteomyelitis in severely immunocompromised patient

A case study has been published on the treatment of Fusarium osteomyelitis in an immunocompromised patient.

Diabetic foot osteomyelitis (DFO) is a severe complication of diabetic foot ulcerations (DFU) but Fusarium osteomyelitis in people who are severely immunocompromised is not well documented.

Fusarium is an invasive fungal species that does not respond well to antifungal therapy alone, and bone debridement is normally required. Treatment options for DFO may include surgical amputation, antimicrobial therapy, and/or conservative surgery or bone debridement.

A team from the University of Michigan Medical School, led by Dr Sari J Priesand, has reported on a case of Fusarium osteomyelitis in a 77-year-old woman with type 2 diabetes and acute myeloid leukaemia, who was undergoing chemotherapy.

She had a DFU to the second digit, with DFO suggested by magnetic resonance imaging. Bone cultures revealed coagulase-negative staphylococci and Fusarium species.

Due to her severely immunocompromised state, the patient was treated with conservative surgery and joint antifungal and antibiotic therapy. The DFU healed in six weeks with no reoccurrence at six months.

The study authors concluded: “This case report, to the authors’ knowledge, is the first to demonstrate successful remission of Fusarium osteomyelitis with a conservative procedure and adjunct antifungal therapy in an immunocompromised patient.”