{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:52:42Z","timestamp":1792068762053,"version":"4.4.0"},"reference-count":16,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T00:00:00Z","timestamp":1689552000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Fungal osteomyelitis is considered a rare disease, and the published literature mainly comprises case reports, case series and narrative reviews. A systematic review was undertaken to provide a practice-based global perspective on this disease, focusing on epidemiology and treatment strategies. We searched MEDLINE, EMBASE and Cochrane Library between the 3rd and 8th of March 2023 using a predefined search string. We included studies with at least one patient with a diagnosis of fungal osteomyelitis published before the 1st of January 2023. We included all study designs except for reviews, and we excluded non-English languages and grey literature. After exclusion, 678 studies, mostly case reports, were included. Descriptive analysis was performed on 1072 patients. The most common aetiological agent was Aspergillus (26.5%), followed by Candida (20.7%) and Mucor (16.8%), and the bones most frequently involved were the vertebrae. We described the characteristics of patients divided by site of infection, and we found that diabetes mellitus, disseminated fungal infection, surgery and local lesion were major risk factors. We also successfully associated duration of treatment with outcome. We provided a general overview of this rare disease, and we highlighted the need for high-quality investigations on the subject.<\/jats:p>","DOI":"10.3390\/microorganisms11071828","type":"journal-article","created":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T01:35:16Z","timestamp":1689644116000},"page":"1828","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Fungal Osteomyelitis: A Systematic Review of Reported Cases"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1618-8867","authenticated-orcid":false,"given":"Erika","family":"Asperges","sequence":"first","affiliation":[{"name":"S.C. Malattie Infettive I Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Albi","sequence":"additional","affiliation":[{"name":"Department of Electrical, Computer and Biomedical Engineering, Universit\u00e0 di Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Truffelli","sequence":"additional","affiliation":[{"name":"S.C. Malattie Infettive I Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"},{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche\u2014Universit\u00e0 di Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Salvaderi","sequence":"additional","affiliation":[{"name":"S.C. Malattie Infettive I Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"},{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche\u2014Universit\u00e0 di Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Puci","sequence":"additional","affiliation":[{"name":"S.C. Malattie Infettive I Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"},{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche\u2014Universit\u00e0 di Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelia","family":"Sangani","sequence":"additional","affiliation":[{"name":"S.C. Malattie Infettive I Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"},{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche\u2014Universit\u00e0 di Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Zuccaro","sequence":"additional","affiliation":[{"name":"S.C. Malattie Infettive I Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9240-2901","authenticated-orcid":false,"given":"Valeria","family":"Scotti","sequence":"additional","affiliation":[{"name":"UOSD Grant Office, TTO e Documentazione Scientifica, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Orsolini","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Interna e Terapia Medica, Universit\u00e0 di Pavia, 27100 Pavia, Italy"},{"name":"S.C. Malattie Infettive I Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Brunetti","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche\u2014Universit\u00e0 di Pavia, 27100 Pavia, Italy"},{"name":"S.C. Malattie Infettive I Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0235-9207","authenticated-orcid":false,"given":"Raffaele","family":"Bruno","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche\u2014Universit\u00e0 di Pavia, 27100 Pavia, Italy"},{"name":"S.C. Malattie Infettive I Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kayser, F.H., Bienz, K.A., Eckert, J., and Zinkernagel, R.M. (2005). Medical Microbiology, Georg Thieme Verlag.","DOI":"10.1055\/b-005-148876"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"110550","DOI":"10.1016\/j.biopha.2020.110550","article-title":"Immune defence to invasive fungal infections: A comprehensive review","volume":"130","author":"Pathakumari","year":"2020","journal-title":"Biomed. Pharmacother."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1007\/s12281-014-0200-3","article-title":"Epidemiology of Fungal Osteomyelitis","volume":"8","author":"Gamaletsou","year":"2014","journal-title":"Curr. Fungal Infect. 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