Table 6.
Treatment and Outcome According to Site of Infection
| Intervention | All cases N (%) | Vertebral Aspergillosis n (%) | Cranial Aspergillosis n (%) | Rib and/or Sternal Osteomyelitis* n (%) | Femoral and/or Tibial Osteomyelitis* n (%) | Others n (%) |
|---|---|---|---|---|---|---|
| 180 | 83 (46) | 41 (23) | 33 (18) | 22 (12) | 7 (4) | |
| MEDICAL THERAPYa | ||||||
| Only Antifungal Agents | 44 (24) | 18 (22) | 10 (24) | 10 (30) | 6 (27) | 0 (0) |
| Only Surgery | 12 (7) | 6 (7) | 2 (5) | 2 (6) | 1 (5) | 1 (14) |
| Antifungal Agents and Surgery | 121 (67) | 58 (70) | 28 (68) | 19 (58) | 15 (68) | 1 (14) |
| Median | 90 d | 90 d | 90 d | 165 d | 218 d | 150 d |
| Duration of Medical Treatment [range] | [10-772] | [14-772] | [10-365] | [23-540] | [10-395] | [10-410] |
| SURGICAL INTERVENTION | ||||||
| Debridement | 124 (69) | 60 (72) | 29 (71) | 16 (48) | 16 (73) | 3 (45) |
| Amputation | 21 (12) | 1 (1)* | 0 (0) | 13 (39) | 1 (5) | 6 (86) |
| Drainage | 27 (15) | 12 (14) | 6 (15) | 4 (12) | 5 (23) | 0 (0) |
| Bone grafting | 18 (10) | 16 (19) | 0 (0) | 0 (0) | 0 (0) | 2 (28) |
| Stabilization | 14 (8) | 13 (16) | 0 (0) | 0 (0) | 0 (0) | 1 (14) |
| Decompression | 10 (6) | 10 (12) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Fixation | 9 (5) | 6 (7) | 0 (0) | 1 (3) | 2 (9) | 0 (0) |
| Lavage | 1 (1) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 1 (14) |
| Intervertebral body fusion | 5 (3) | 5 (6) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Removal of hardware | 2 (1) | 1 (1) | 0 (0) | 0 (0) | 0 (0) | 1 (14) |
| Insertion of prosthesis | 2 (1) | 1 (1) | 0 (0) | 0 (0) | 0 (0) | 1 (14) |
| OUTCOME | ||||||
| Complete response | 101 (56) | 45 (54) | 24 (58) | 15 (45) | 15 (68) | 6 (86) |
| Partial response | 51 (28) | 22 (27) | 13 (32) | 12 (36) | 4 (18) | 0 (0) |
| Relapse | 18 (10) | 7 (8) | 5 (12) | 6 (18) | 0 (0) | 0 (0) |
| Death | 45 (25) | 19 (23) *6 Aspergillus-related-deaths | 13 (32) *3 Aspergillus-related-deaths | 7 (21) *2 Aspergillus-related-deaths | 5 (23) | 1 (14) *1 Aspergillus-related-deaths |
a
data were insufficient for 3 patients to define the type of medical or surgical management
*
ribs alone (n=23)
*
sternum alone (n=5)
*
ribs and sternum (n=5)