Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 May-Jun;50(3):327-30.
doi: 10.4103/0019-5413.181783.

Septic arthritis due to tubercular and Aspergillus co-infection

Affiliations

Septic arthritis due to tubercular and Aspergillus co-infection

Mukesh Kumar et al. Indian J Orthop. 2016 May-Jun.

Abstract

Aspergillus septic arthritis is a rare and serious medical and surgical problem. It occurs mainly in immunocompromised patients. Aspergillus fumigatus is the most common causative organism followed by Aspergillus flavus. The most common site affected is knee followed by shoulder, ankle, wrist, hip and sacroiliac joint. Debridement and voriconazole are primary treatment of articular aspergilosis. To the best of our knowledge, there are no reported cases of co-infection of tuberculosis (TB) and Aspergillus infecting joints. We report a case of co-infection of TB and A. flavus of hip and knee of a 60-year-old male, with type 2 diabetes mellitus. He was treated with debridement, intravenous voriconazole, and antitubercular drugs.

Keywords: Aspergillus; Aspergillus flavus; arthritis; aspergillus septic arthritis; fungi; infections; joint tuberculosis; septic; tuberculosis; voriconazole.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None.

Figures

Figure 1
Figure 1
Anteroposterior radiograph of pelvis showing narrowing of joint space, subchondral erosion and osteopenia around the right hip joint
Figure 2
Figure 2
Radiograph of knee anteroposterior/lateral views showing narrowing of joint space, subchondral erosion, osteopenia and osteophytes around the knee joint
Figure 3
Figure 3
Magnetic resonance imaging T2 short tau inversion recovery image - minimal effusion of right hip joint, altered bone marrow signals in head and proximal femur and acetabulum, soft tissue edema around the hip joint
Figure 4
Figure 4
Bone scan: Intense tracer uptake seen in L4 L5 S1 vertebrae, right sacroiliac joint, right hip and knee joints? Acute infective/inflammatory pathology
Figure 5
Figure 5
Modified Sabouraud dextrose agar showing rugose yellow, green colonies of Aspergillus flavus
Figure 6
Figure 6
Lactophenol cotton blue stain showing long conidiophores and a single globose vesicle covered entirely on its surface by uniseriate phialides suggestive of Aspergillus flavus (×400)
Figure 7
Figure 7
Radiograph of the chest posteroanterior view showing the opacity in right lower lobe

Similar articles

Cited by

References

    1. Golmia R, Bello I, Marra A, Hamerschlak N, Osawa A, Scheinberg M. Aspergillus fumigatus joint infection: A review. Semin Arthritis Rheum. 2011;40:580–4. - PubMed
    1. Dal T, Tekin A, Deveci Ö, Bulut M, Fırat U, Mete M. Septic arthritis caused by Aspergillus fumigatus in an immunosuppressive patient: A case report and review of the literature. J Microbiology and Infectious Diseases. 2012;2:29–32.
    1. Cuellar ML, Silveira LH, Espinoza LR. Fungal arthritis. Ann Rheum Dis. 1992;51:690–7. - PMC - PubMed
    1. Walsh TJ, Anaissie EJ, Denning DW, Herbrecht R, Kontoyiannis DP, Marr KA, et al. Treatment of aspergillosis: Clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis. 2008;46:327–60. - PubMed
    1. Kaya A, Topu Z, Fitoz S, Numanoglu N. Pulmonary tuberculosis with multifocal skeletal involvement. Monaldi Arch Chest Dis. 2004;61:133–5. - PubMed

LinkOut - more resources