Cryptococcal osteomyelitisof the proximal humerus:A case report and literature review
YE Yongxian
ZHAO Jiali
HONG Haisen
ZHU Lingqi
LIN Jinhe
SHA Mo
Abstract：A clinical case of cryptococcal osteomyelitis of the proximal humerus confirmed by histopathology and next-gen-eration sequencing was reported,and the literature was reviewed and analyzed based on relevant domestic and international reports.A 31-year-old woman with a history of type 1 diabetes showed pain and discomfort in the left shoulder joint for more than 2 months.Computed tomography(CT)revealed bone destruction of the left humeral head,and magnetic resonance im-aging(MRI)indicated aseptic necrosis of the same area.The surgical lesion was removed and the pathological examination revealed a granulomatous lesion of the left humerus.It was diagnosed as fungal infection via immunohistochemistry and spe-cial staining,and Cryptococcus was foundas pathogen.The second-generation sequencing showed that Cryptococcus neofor-mans was the main suspected pathogen.Fluconazole therapy was given.After 8 months of follow-up,the scope of the lesion was significantly reduced,and the infection was well controlled.Isolatedcryptococcal infection of the skeletal system wasrare and couldbe easily misdiagnosed as tumors,tuberculosis orother diseases.The diagnosis mainly depends on pathological ex-amination and microbial culture.As an emerging detection technology,next-generation sequencing can be used as an impor-tant basis for diagnosis.The prognosis is good after surgical lesion removal combined with oral antifungal therapy.
Keywords：Cryptococcusproximal humerusnext-generation sequencingimmunohistochemistrymicrobial culture
Publication Date：2025-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 289-293 )