Abstract：
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.
Localized osteoarticular scedosporiosis mostly occurs following direct inoculation. Management was most often based on voriconazole therapy and concomitant surgery. Unlike other invasive scedosporiosis, no patient died during follow-up.
Localized osteoarticular scedosporiosis mostly occurs following direct inoculation. Management was most often based on voriconazole therapy and concomitant surgery. Unlike other invasive scedosporiosis, no patient died during follow-up.
摘要：
关于局部骨关节头孢孢子虫病（LOS）知之甚少。大多数数据来自病例报告和小病例系列。在这里，我们提出了一项全国性的法国头孢孢子虫病观察研究（SOS）的辅助研究，描述了2005年1月至2017年3月期间诊断的15例连续LOS病例。包括诊断为骨关节受累而定义为LOS的成年患者，而没有SOS中报告的远处病灶。分析了15个LOS。7名患者有潜在疾病。14例患者先前有创伤作为潜在的接种。临床表现为关节炎（n=8），骨炎（n=5）和胸壁感染（n=2）。最常见的临床表现是疼痛（n=9），其次是局部肿胀(n=7)，皮肤造瘘（n=7）和发热（n=5）。涉及的物种是cedosporiumapiospermum（n=8），S.boydii(n=3)，S.dehoogii(n=1)，和长龙孢菌(n=3)。除了与医疗保健相关的接种相关的博伊迪菌，物种分布并不显著。13例患者的管理基于内科和外科治疗。14名患者接受抗真菌治疗，中位持续时间为7个月。随访期间无患者死亡。LOS仅发生在接种或全身诱发因素的情况下。它具有非特异性临床表现，并且如果抗真菌治疗的疗程延长和适当的手术管理，则与总体良好的临床结果相关。
局部的骨关节scedosporiosis大多发生在直接接种后。管理通常基于伏立康唑治疗和伴随手术。与其他侵袭性孢子虫病不同，随访期间无患者死亡.
局部的骨关节scedosporiosis大多发生在直接接种后。
