Musculoskeletal Manifestations of Disseminated Fungal Infections.

Abstract

» Disseminated musculoskeletal fungal infections, though rare, present significant diagnostic and therapeutic challenges, affecting both immunocompromised and previously healthy individuals. » Ubiquitous species (spp.) such as <i>Candida</i>, <i>Aspergillus</i>, and <i>Cryptococcus</i> contrast with dimorphic fungi, including <i>Histoplasma capsulatum</i>, <i>Blastomyces</i> spp., and <i>Coccidioides</i> spp., which are endemic to specific regions. » These infections typically present insidiously, with non-specific symptoms such as fever, joint pain, and swelling that mimic autoimmune, bacterial, or viral diseases, often leading to delayed diagnosis. » Initial evaluation often includes radiographs, which may reveal lytic bone lesions, particularly in the metaphyses of long bones, as well as in less conspicuous sites such as the talus and cuboid. Even with this information, a definitive diagnosis still requires histological or microbiological evidence prior to initiating some antifungal treatments. » This review synthesizes current knowledge on disseminated musculoskeletal fungal infections, emphasizing their epidemiology, pathogenesis, clinical manifestations, diagnostic strategies, and treatment.