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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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Volume 4, issue 5
J. Bone Joint Infect., 4, 209–215, 2019
https://doi.org/10.7150/jbji.38120
© Author(s) 2019. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 4, 209–215, 2019
https://doi.org/10.7150/jbji.38120
© Author(s) 2019. This work is distributed under
the Creative Commons Attribution 4.0 License.

Original full-length article 18 Sep 2019

Original full-length article | 18 Sep 2019

Bone and Joint Infections among Hematopoietic Stem Cell Transplant Recipients

Cybele Lara Abad1, Vania Phuoc2, Prashant Kapoor3, Pritish K. Tosh4, Irene G. Sia4, Douglas R. Osmon4, and Aaron J. Tande4 Cybele Lara Abad et al.
  • 1Department of Internal Medicine, Section of Infectious Diseases, University of the Philippines-Manila, Philippine General Hospital, Manila Philippines;
  • 2Division of Hematology, University of the Philippines-Manila, Philippine General Hospital, Manila Philippines;
  • 3Division of Infectious Diseases, University of the Philippines-Manila, Philippine General Hospital, Manila Philippines;
  • 4Mayo Clinic, Rochester MN, USA.

Keywords: Hematopoietic stem cell transplantation, bone, joint

Abstract. Background: Hematopoietic stem cell transplantation (HSCT) recipients are at increased risk for infection. This study describes bone and joint infections (BJI) among HSCT recipients.

Methods: We reviewed 5861 patients who underwent HSCT at Mayo Clinic, Rochester, MN from January 1, 2005 through January 1, 2015 for study inclusion. BJI was defined as native septic arthritis, prosthetic joint infection, osteomyelitis, and orthopedic implant infection. All adults with BJI after HSCT were included in the analysis.

Results: Of 5861 patients, 33 (0.6%) developed BJI. Native joint septic arthritis was the most common BJI occurring in 15/33 (45.4%) patients. Patients were predominantly male (24/33, 72.7%), with median age of 58 (range 20-72) years. BJI was diagnosed a median of 39 (range 1-114) months after allogeneic (14/33, 42.4%) or autologous (19/33, 57.6%) HSCT. Organisms were recovered via tissue (24/27, 88.9%), synovial fluid (13/17, 76.5%), and/or blood cultures (16/25, 64%). Most underwent surgical debridement (23/33, 69.7%). Patients were followed a median of 78.3 months (range 74-119). Therapy was unsuccessful in 4/33 (12.1%), with death related to the underlying BJI in two (50%). Failure occurred a median of 3.4 (0.1-48.5) months from diagnosis. At last follow up, 7/33 (21.2%) patients were alive. Median overall survival was 13 months (0.07-70.6).

Conclusion: BJI among HSCT recipients is infrequent. The most common infection is native joint septic arthritis. Pathogens appear similar to patients without HSCT. Treatment involving surgical-medical modalities is successful, with most patients surviving >1 year after BJI.

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