Cryptococcus neoformans osteomyelitis of the clavicle
Magid, D.; Smith, B.
Orthopedics 15(9): 1068-1070
1992
ISSN/ISBN: 0147-7447 PMID: 1437867 Document Number: 396864
A case of osteomyelitis is reported in a 54-yr-old diabetic woman who presented with a 1-month history of progressive left shoulder pain and loss of range of motion associated with an enlarging clavicular mass. A tender, firm mass (10 x 12 cm) was visible and palpable over the proximal aspect of the left clavicle. Computed tomography revealed a 6 cm inflammatory chest wall mass centred around the left clavicular head with focal lytic destruction of the medial aspect of this bone. Histochemical staining of material from fine needle aspiration of the clavicular soft tissue mass revealed Cryptococcus neoformans, and latex agglutination for serum cryptococcal antigen was positive at 1:256. The patient responded to intravenous amphotericin B and oral 5-flucytosine and she was discharged on amphotericin B. After 10 months, computed tomography revealed ongoing clavicular healing and decreased soft tissue mass.