1887

Abstract

Introduction:

Mucormycosis is a rare fungal infection, but can cause substantial morbidity and mortality in both immunocompromised and immunocompetent patients. is a mucormycetes species ubiquitous in nature, particularly in soil, decaying wood and other organic matter. is known to cause cutaneous fungal infections, particularly after penetrating trauma. Septic arthritis is a rare clinical manifestation.

Case presentation:

We describe a case of causing septic arthritis of the knee of a patient with multiple myeloma. He was treated multiple times for bacterial septic arthritis with minimal improvement. Surgical tissue specimens finally grew mucoraceous mould, and DNA sequencing and morphological assessment of spores identified the mould as . The patient was treated with amphotericin B and posaconazole, but ultimately required an above-the-knee amputation for definitive treatment.

Conclusion:

This case illustrates the need to evaluate for fungal infection in a persistent septic arthritis that is culture negative and refractory to empiric antibiotics, particularly in an immunocompromised individual. It also shows the importance of a thorough social history and adequate tissue specimens for culture.

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2016-11-01
2021-10-18
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References

  1. Chakrabarti A., Shivaprakash M. R., Curfs-Breuker I., Baghela A., Klaassen C. H., Meis J. F. 2010; Apophysomyces elegans: epidemiology, amplified fragment length polymorphism typing, and in vitro antifungal susceptibility pattern. J Clin Microbiol 48:4580–4585 [View Article][PubMed]
    [Google Scholar]
  2. Echaiz J. F., Burnham C. A., Bailey T. C. 2013; A case of Apophysomyces trapeziformis necrotizing soft tissue infection. Int J Infect Dis 17:e1240e1242 [View Article][PubMed]
    [Google Scholar]
  3. Gomes M. Z., Lewis R. E., Kontoyiannis D. P. 2011; Mucormycosis caused by unusual mucormycetes, non-Rhizopus, -Mucor, and -Lichtheimia species. Clin Microbiol Rev 24:411–445 [View Article][PubMed]
    [Google Scholar]
  4. Kumashi P. R., Safdar A., Chamilos G., Chemaly R. F., Raad I. I., Kontoyiannis D. P. 2006; Fungal osteoarticular infections in patients treated at a comprehensive cancer centre: a 10-year retrospective review. Clin Microbiol Infect 12:621–626 [View Article][PubMed]
    [Google Scholar]
  5. Mostaza J. M., Barbado F. J., Fernandez-Martin J., Peña-Yañez J., Vazquez-Rodriguez J. J. 1989; Cutaneoarticular mucormycosis due to Cunninghamella bertholletiae in a patient with AIDS. Rev Infect Dis 11:316–318 [View Article][PubMed]
    [Google Scholar]
  6. Neblett Fanfair R., Benedict K., Bos J., Bennett S. D., Lo Y. C., Adebanjo T., Etienne K., Deak E., Derado G. et al. 2012; Necrotizing cutaneous mucormycosis after a Tornado in Joplin, Missouri, in 2011. N Engl J Med 367:2214–2225 [View Article][PubMed]
    [Google Scholar]
  7. Padhye A. A., Ajello L. 1988; Simple method of inducing sporulation by Apophysomyces elegans and Saksenaea vasiformis . J Clin Microbiol 26:1861–1863[PubMed]
    [Google Scholar]
  8. Parra-Ruiz J., Peña-Monje A., Tomas-Jimenez C., Antelo-Lorenzo R., Escobar-Lara T., Hernández-Quero J. 2008; Septic arthritis due to Absidia corymbifera in a patient with HIV-1 infection. Infection 36:279–281 [View Article][PubMed]
    [Google Scholar]
  9. Roden M. M., Zaoutis T. E., Buchanan W. L., Knudsen T. A., Sarkisova T. A., Schaufele R. L., Sein M., Sein T., Chiou C. C. et al. 2005; Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis 41:634–653 [View Article][PubMed]
    [Google Scholar]
  10. Vaezi A., Moazeni M., Rahimi M. T., de Hoog S., Badali H. 2016; Mucormycosis in Iran: a systematic review. Mycoses 59:402–415 [View Article][PubMed]
    [Google Scholar]
  11. Walsh T. J., Gamaletsou M. N., McGinnis M. R., Hayden R. T., Kontoyiannis D. P. 2012; Early clinical and laboratory diagnosis of invasive pulmonary, extrapulmonary, and disseminated mucormycosis (zygomycosis). Clin Infect Dis 54:S55–60 [View Article][PubMed]
    [Google Scholar]
  12. White T. J., Bruns T., Lee S., Taylor J. W. 1990; Amplification and direct sequencing of fungal ribosomal RNA genes for phylogenetics. In PCR Protocols-a Guide to Methods and Applications pp. 315–322Edited by Innis M. A., Gelfand D. H., Sninsky J. J., White T. J. New York, NY: Academic Press, Inc;
    [Google Scholar]
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