Osteomyelitis of the rib cage by Aspergillus flavus

Abstract

Background: Aspergillus osteomyelitis of the ribs is relatively uncommon. It is a debilitating and severe form of invasive aspergillosis.

Case report: A 61year-old female presented with spontaneous chest pain on the right side of the rib cage and a palpable soft-tissue mass. FDG-PET/CT scan identified activity in the infected site. The lesion was punctured, and purulent material was sent to the laboratory. Aspergillus complex Flavi was isolated. An antifungal treatment with voriconazole was started. The lesion healed, and no recurrence was observed at 8-month follow-up. Molecular identification of the isolate was based on PCR amplification and sequencing of β-tubulin gene. Aspergillus flavus was identified.

Conclusions: Our case highlights the relevance of microbiological studies in patients with osteomyelitis and the involvement of soft tissue. The FDG-PET/CT scan was found to be a useful tool for revealing the extent of the disease and evaluating the response to the antifungal therapy.

Keywords: Aspergillus flavus; Aspergillus section Flavi complex; Complejo Aspergillus sección Flavi; Gen de la β-tubulina; Ibrutinib; Osteomielitis; Osteomyelitis; β-Tubulin gene.