{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T18:14:48Z","timestamp":1792692888291,"version":"4.5.0"},"reference-count":11,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,12,21]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                  <jats:italic>Scedosporium apiospermum<\/jats:italic> is a ubiquitous environmental fungus, and several osteomyelitis cases have been reported in recent years. We present the case of a woman in her 70s who sustained a comminuted open ankle fracture, with garden soil contamination of the wound, which was treated according to orthoplastic principles. The patient developed osteomyelitis 6\u2009months postsurgery. Intraoperative samples from the debridement and removal of metalwork showed the growth of <jats:italic>S. apiospermum<\/jats:italic>, and the patient was treated with antifungal therapy and surgical debridements. The successful recovery of the patient highlights the possibility of treating fungal osteomyelitis when promptly diagnosed, raising the need for clinical suspicion. The interpretation of the significance of an environmental isolate was aided by a clear recording of not only the mechanism of injury but also the environment where it occurred. Hence, clear documentation and description of open fractures are paramount to patients\u2019 care.<\/jats:p>","DOI":"10.1136\/bcr-2024-262456","type":"journal-article","created":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T07:00:39Z","timestamp":1736838039000},"page":"e262456","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Delayed <i>Scedosporium apiospermum<\/i> osteomyelitis following an open ankle fracture in an immunocompetent patient"],"prefix":"10.1136","volume":"18","author":[{"given":"Andreas","family":"Papaleontiou","sequence":"first","affiliation":[{"name":"Foundation Year 2 Doctor, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9a","family":"Poupard","sequence":"additional","affiliation":[{"name":"University of Birmingham Birmingham Medical School, Birmingham, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciaran Declan","family":"Nolan","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Mortiboy","sequence":"additional","affiliation":[{"name":"Infection Services, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,1,14]]},"reference":[{"key":"2025082802145516000_18.1.e262456.1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1111\/j.1600-0560.2008.01208.x","article-title":"Scedosporium apiospermum: an emerging opportunistic pathogen that must be distinguished from Aspergillus and other hyalohyphomycetes","volume":"36 Suppl 1","author":"Shinohara","year":"2009","journal-title":"J Cutan Pathol"},{"key":"2025082802145516000_18.1.e262456.2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.05910-11"},{"key":"2025082802145516000_18.1.e262456.3","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00039-07"},{"key":"2025082802145516000_18.1.e262456.4","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.1.62-68.2002"},{"key":"2025082802145516000_18.1.e262456.5","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.mmcr.2016.04.005","article-title":"Scedosporium apiospermum infections and the role of combination antifungal therapy and GM-CSF: A case report and review of the literature","volume":"11","author":"Goldman","year":"2016","journal-title":"Med Mycol Case Rep"},{"key":"2025082802145516000_18.1.e262456.6","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01388-07"},{"key":"2025082802145516000_18.1.e262456.7","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1177\/107110079701800307","article-title":"Salvage of the septic ankle with concomitant tibial osteomyelitis","volume":"18","author":"Thordarson","year":"1997","journal-title":"Foot Ankle Int"},{"key":"2025082802145516000_18.1.e262456.8","doi-asserted-by":"crossref","DOI":"10.1177\/24730114221112934","article-title":"Ankle Fusion After Prolonged Scedosporium boydii (Pseudallescheria boydii) Infection Following Open Trimalleolar Fracture","volume":"7","author":"Jackson","year":"2022","journal-title":"Foot Ankle Orthop"},{"key":"2025082802145516000_18.1.e262456.9","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.1.106-117.2003"},{"key":"2025082802145516000_18.1.e262456.10","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ482"},{"key":"2025082802145516000_18.1.e262456.11","doi-asserted-by":"crossref","first-page":"3219","DOI":"10.1007\/s00018-020-03736-z","article-title":"Mechanisms of fungal dissemination","volume":"78","author":"Strickland","year":"2021","journal-title":"Cell Mol Life Sci"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-262456","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:15:05Z","timestamp":1756372505000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-262456"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,14]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2024-262456"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-262456","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}