Table 1.
Summary of cases of Cryptococcal osteomyelitis in HIV-Negative patients
| Year | Country | Age(years) /Sex |
Location | Initial diagnosis | Fundamental disease |
Diagnostic methods | First-line therapy |
Surgery | Outcome |
|---|---|---|---|---|---|---|---|---|---|
| 2025[8] | India | 35/M |
Tibia, Radius |
Diagnosis remained unestablished |
Post-renal, transplantation, Tuberculosis, Diabetes mellitus |
Culture, Histopathological examination |
Intravenous liposomal amphotericin B (L-AMB) 200 mg daily (5 mg/kg/day); Oral flucytosine 1250 mg every 6 h. | YES | Cured |
| 2025[9] | USA | 89/M | Spine | Diagnosis remained unestablished | NO |
Culture, CrAg |
Liposomal Amphotericin B | NO | Improved |
| 2025[10] | India | 27/M | Calcaneus, Tibia | Tuberculosis | Leprosy |
Culture, Histopathological examination |
liposomal amphotericin B (3 mg/kg IV daily), oral fluconazole (400 mg daily) |
YES | Cured |
| 2024[11] | India | 27/M | Calcaneus, Tibia | Diagnosis remained unestablished | Leprosy |
Culture, Histopathological examination |
Fluconazole (400 mg daily) for long-term | YES | Cured |
| 2024[12] | China | 41/F | Radius | Bacterial osteomyelitis | Chronic hepatitis B |
Culture, Histopathological examination, mNGS |
Oral fluconazole consolidation therapy: 200 mg twice daily for 12 weeks. | YES | Cured |
| 2024[13] | China | 28/M | multiple bones | Diagnosis remained unestablished | Chronic hepatitis B | Culture | Initial therapy: IV amphotericin B + oral flucytosine for 4 weeks.Consolidation: Oral fluconazole for 1 year. | NO | Cured |
| 2024[14] | China | 56/F | Spine | Tuberculosis | Tuberculosis |
Histopathological examination, CrAg, |
Induction: Amphotericin B (0.6 mg/kg/day IV) + flucytosine (100 mg/kg/day PO) × 4 weeks | NO | Cured |
| Consolidation: Fluconazole 400 mg/day PO × 8 weeks | |||||||||
| Maintenance: Fluconazole 200 mg/day PO ≥ 6 months | |||||||||
| 2024[15] | United States | 45/M | Humeral | Pneumonia |
Esophageal Adenocarcinoma, Crohn’s Disease |
Culture, CrAg, |
Flucytosine (5-FC) and Amphotericin B | YES | Death |
| 2024[16] | China | 67/F |
Ankle, Fibula |
Tuberculosis | Tuberculosis |
mNGS, Histopathological examination, CrAg |
Flucytosine 1 g IV q12h × 25 d + Fluconazole 400 mg IV daily → Fluconazole 300 mg PO daily × 12mo | YES | Cured |
| 2023[17] | China | 37/M | Sacrum |
Tumor, Tuberculosis |
NO | Culture, Histopathological examination | IV fluconazole (4 weeks) → Oral fluconazole consolidation (8 weeks) | YES | Cured |
| 2023[18] | Australia | 53/M | Spine | Diagnosis remained unestablished | HLA-B27-associated chronic uveitis, hypertension |
Histopathological examination, CrAg |
Induction: Liposomal amphotericin B + flucytosine × 4 weeks→ Consolidation & maintenance: Fluconazole | NO | Cured |
| 2023[19] | India | 42/M | Ischial, Pubis | Diagnosis remained unestablished | Diabetes |
Histopathological examination, CrAg |
Liposomal amphotericin B IV + Flucytosine IV→ Fluconazole 400 mg daily × 6 months | YES | Cured |
| 2023[20] | Greece | 82/F | Tibia | Diagnosis remained unestablished |
Diabetes, Chronic Kidney Disease, Rheumatoid Arthritis |
Culture | Fluconazole IV loading dose 800 mg → 400 mg daily × 3 weeks → Fluconazole 200 mg PO every 12 h × 9 months | YES | Cured |
| 2023[21] | China | 16/F | Disseminated Cryptococcal Infection Without Specified Osteomyelitis Site | Tumor |
Idiopathic Thrombocytopenic Purpura, Yolk Sac Tumor, |
Culture | Fluconazole IV (loading 800 mg → 400 mg daily) + Flucytosine 150 mg 6 h, Added Liposomal Amphotericin B 60 mg/day IV | NO | Cured |
| 2023[22] | China | 31/F | Acetabulum | Diagnosis remained unestablished | Chronic hepatitis B | Histopathological examination | Fluconazole and Flucytosine | NO | Cured |
| 2022[23] | United States | 46/F | Rib | Pneumonia | Multiple sclerosis |
Culture, CrAg |
Liposomal amphotericin B IV + Flucytosine PO × 2 weeks, Maintenance: Fluconazole 400 mg PO daily × 6–12 months | NO | Cured |
| 2022[24] | Brazil | 20/F | Femur | Bacterial osteomyelitis | NO | Culture, Histopathological examination | Amphotericin B deoxycholate IV × 2 weeks, Fluconazole PO × 6 months (maintenance) | YES | Cured |
| 2022[25] | United States | 29/M | Humerus | Skin and subcutaneous infections | NO |
Culture, CrAg |
Fluconazole 800 mg once daily for 2 weeks → 400 mg once daily for 6 months | YES | Cured |
| 2022[26] | China | 79/F | Ulna | Bacterial osteomyelitis | NO | Culture | Fluconazole 200 mg IV twice daily → transitioned to oral 400 mg once daily. | YES | Cured |
| 2022[27] | China | 45/F | Pubis | Tumor | NO | Culture, Histopathological examination | luconazole 400 mg daily for 16 weeks | NO | Cured |
| 2022[28] | United States | 50/F | Femoral, Humeral | Multiple myeloma | NO |
Culture, Histopathological examination, CrAg |
Liposomal amphotericin B IV + Flucytosine PO × 2 weeks, Fluconazole 400 mg/day PO × 8 weeks, Fluconazole 200 mg/day PO × 12 months | NO | Cured |
| 2022[29] | USA | 36/M | Tibia | Diagnosis remained unestablished |
Chronic hepatitis B, Tuberculosis |
Culture, | Fluconazole and Amphotericin B | YES | Cured |
| 2022[30] | China | 41/M | Spine | Tumor | NO |
Histopathological examination, mNGS |
Discontinued flucytosine + amphotericin B 5 days, Fluconazole 400 mg daily | YES | Cured |
| 2021[31] | China | 46/F | Spine | Tumor | Sjögren’s Syndrome | Histopathological examination | Fluconazole 400 mg daily for 6 months | NO | Cured |
| 2021[32] | USA | 11/M | Rib | Bacterial osteomyelitis | Lung Transplantation |
Culture, Histopathological examination, CrAg |
Fluconazole 400 mg daily + Flucytosine 750 mg q6h × 14mo | NO | Cured |
| 2021[33] | Argentina | 69/F | Calcaneus | Diagnosis remained unestablished | Renal Transplantation | Histopathological examination | Liposomal amphotericin B 3 mg/kg/day IV × 25 days, Fluconazole 400 mg/day PO × 8 weeks | YES | Cured |
| 2020[34] | India | 20/M | Rib | Tuberculosis | Primary T-Cell Immunodeficiency | Histopathological examination | Liposomal amphotericin B 4 mg/kg/day IV + Flucytosine 100 mg/kg/day PO in 4 divided doses × 6 weeks, Fluconazole 800 mg/day PO × 8 weeks | NO | Cured |
| 2020[35] | Japan | 70/M | Humerus | Bacterial osteomyelitis | Multiple Sclerosis |
Histopathological examination, CrAg |
Fluconazole 400 mg/day PO × 5 months,200 mg/day PO × 17 months | YES | Cured |