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. 2016 May-Jun;50(3):327-30.
doi: 10.4103/0019-5413.181783.

Septic arthritis due to tubercular and Aspergillus co-infection

Mukesh Kumar  1 , Jai Thilak  1 , Adnan Zahoor  1 , Arun Jyothi  1
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.

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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
See this image and copyright information in PMC

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