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Aspergillus infection after total knee arthroplasty
Philip Langer1, Rida A Kassim, George S Macari
1Department of Orthopaedics, Clinical Outcome Research Center, Health Services Research and Policy School of Public Health, University of Minnesota, Minneapolis, USA.
American Journal of Orthopedics (Belle Mead, N.J.)
|August 29, 2003
Summary
This case study details a rare Aspergillus niger infection following total knee arthroplasty in a healthy patient. Treatment involved amphotericin B and oral antifungals, leading to a successful recovery.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Mycology
Background:
- Total knee arthroplasty (TKA) is a common orthopedic procedure.
- Postoperative infections can complicate TKA, with fungal infections being rare.
- Aspergillus niger is an opportunistic fungus that can cause infection.
Observation:
- A non-immunocompromised patient without risk factors developed Aspergillus niger infection after TKA.
- Initial presentation mimicked aseptic loosening.
- Intraoperative cultures were negative, but postoperative cultures revealed heavy A. niger growth.
Findings:
- The patient received a 6-week course of intravenous amphotericin B.
- Oral antifungal therapy was administered subsequently.
- The patient showed no symptoms 12 months post-surgery.
Implications:
- This case highlights the possibility of Aspergillus infection after TKA even in low-risk patients.
- It underscores the importance of considering fungal etiologies in persistent postoperative infections.
- Successful treatment protocols involving amphotericin B and oral antifungals are demonstrated.