Invasive bone and joint infections from the French Scedosporiosis/lomentosporiosis Observational Study (SOS) cohort: no mortality with long-term antifungal treatment and surgery
Damien Blez
(1)
,
Didier Bronnimann
(2)
,
Blandine Rammaert
(3, 4, 5)
,
Valérie Zeller
(6)
,
Laurence Delhaes
(7, 2)
,
Laurent Hustache
(8)
,
Frédéric Grenouillet
(9, 8)
,
Nicolas Traversier
(10)
,
Julie Bonhomme
(11)
,
Taieb Chouaki
(12)
,
Thomas Perpoint
(13)
,
Florence Persat
(13, 14)
,
Marie Elisabeth Bougnoux
(1, 15)
,
Sophie Bayle
(16)
,
Luc Quaesaet
(17)
,
Gilles Nevez
(18)
,
David Boutoille
(19, 20)
,
Florent Morio
(20, 21)
,
Laurence Pougnet
(22)
,
Viviane Queyrel-Moranne
(23)
,
B́eate Heym
(6)
,
Romain Guillemain
(24)
,
Éric Dannaoui
(24, 25)
,
Antoine Roux
(24)
,
Dea Garcia-Hermoso
(15)
,
Fanny Lanternier
(1, 15)
1
Hôpital Necker - Enfants Malades [AP-HP]
2 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
3 PHAR2 [Poitiers] - Pharmacologie des anti-infectieux et antibiorésistance [U 1070]
4 Université de Poitiers - UFR Santé [Faculté de Médecine et de Pharmacie]
5 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
6 Groupe Hospitalier Diaconesses Croix Saint-Simon
7 CRCTB - Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux]
8 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
9 LCE - Laboratoire Chrono-environnement (UMR 6249)
10 Centre hospitalier Félix-Guyon [Saint-Denis, La Réunion]
11 Hôpital Côte de Nacre [CHU Caen]
12 CHU Amiens-Picardie
13 HCL - Hospices Civils de Lyon
14 PI3 - Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques / Pathophysiology of Injury-induced Immunosuppression
15 CNRMA - Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals
16 Centre Hospitalier Henri Duffaut (Avignon)
17 CHU - BREST - Hôpital de la Cavale Blanche - CHRU Brest
18 CHU - BREST - Hôpital Morvan - CHRU de Brest
19 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
20 CIC Nantes - Centre d’Investigation Clinique de Nantes
21 IICiMed - Cibles et Médicaments des Infections et de l'Immunité - UR 1155
22 Hôpital d'Instruction des Armées "Clermont-Tonnerre" (HIA)
23 CHU - Hôpital Pasteur [Nice]
24 HEGP - Hôpital Européen Georges Pompidou [APHP]
25 Hôpital Foch [Suresnes]
2 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
3 PHAR2 [Poitiers] - Pharmacologie des anti-infectieux et antibiorésistance [U 1070]
4 Université de Poitiers - UFR Santé [Faculté de Médecine et de Pharmacie]
5 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
6 Groupe Hospitalier Diaconesses Croix Saint-Simon
7 CRCTB - Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux]
8 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
9 LCE - Laboratoire Chrono-environnement (UMR 6249)
10 Centre hospitalier Félix-Guyon [Saint-Denis, La Réunion]
11 Hôpital Côte de Nacre [CHU Caen]
12 CHU Amiens-Picardie
13 HCL - Hospices Civils de Lyon
14 PI3 - Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques / Pathophysiology of Injury-induced Immunosuppression
15 CNRMA - Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals
16 Centre Hospitalier Henri Duffaut (Avignon)
17 CHU - BREST - Hôpital de la Cavale Blanche - CHRU Brest
18 CHU - BREST - Hôpital Morvan - CHRU de Brest
19 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
20 CIC Nantes - Centre d’Investigation Clinique de Nantes
21 IICiMed - Cibles et Médicaments des Infections et de l'Immunité - UR 1155
22 Hôpital d'Instruction des Armées "Clermont-Tonnerre" (HIA)
23 CHU - Hôpital Pasteur [Nice]
24 HEGP - Hôpital Européen Georges Pompidou [APHP]
25 Hôpital Foch [Suresnes]
Damien Blez
- Fonction : Auteur
- PersonId : 1246369
- ORCID : 0000-0003-1117-9360
Blandine Rammaert
- Fonction : Auteur
- PersonId : 800282
- ORCID : 0000-0002-9346-5848
- IdRef : 123955386
Taieb Chouaki
- Fonction : Auteur
- PersonId : 1412669
- ORCID : 0009-0002-3453-1232
- IdRef : 117515043
David Boutoille
- Fonction : Auteur
- PersonId : 1166275
- ORCID : 0000-0001-9722-2029
Florent Morio
- Fonction : Auteur
- PersonId : 1049989
- IdHAL : florent-morio
- ORCID : 0000-0002-5859-6105
- IdRef : 117992259
Dea Garcia-Hermoso
- Fonction : Auteur
- PersonId : 1273549
- IdHAL : dea-garcia-hermoso
- ORCID : 0000-0001-5288-2904
Résumé
Little is known about localized osteoarticular Scedosporiosis (LOS). Most data come from case reports and small case series. Here we present an ancillary study of the nationwide French Scedosporiosis Observational Study (SOS), describing 15 consecutive cases of LOS diagnosed between January 2005 and March 2017. Adult patients diagnosed with LOS defined by osteoarticular involvement without distant foci reported in SOS were included. Fifteen LOS were analyzed. Seven patients had underlying disease. Fourteen patients had prior trauma as potential inoculation. Clinical presentation was arthritis (n = 8), osteitis (n = 5), and thoracic wall infection (n = 2). The most common clinical manifestation was pain (n = 9), followed by localized swelling (n = 7), cutaneous fistulization (n = 7), and fever (n = 5). The species involved were Scedosporium apiospermum (n = 8), S. boydii (n = 3), S. dehoogii (n = 1), and Lomentospora prolificans (n = 3). The species distribution was unremarkable except for S. boydii, which was associated with healthcare-related inoculations. Management was based on medical and surgical treatment for 13 patients. Fourteen patients received antifungal treatment for a median duration of 7 months. No patients died during follow-up. LOS exclusively occurred in the context of inoculation or systemic predisposing factors. It has a non-specific clinical presentation and is associated with an overall good clinical outcome, provided there is a prolonged course of antifungal therapy and adequate surgical management.