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Aspergillus: a rare primary organism in soft-tissue infections

M A Johnson1, G Lyle, M Hanly

  • 1Department of Surgical Oncology, Medical College of Georgia, Augusta 30912, USA.

The American Surgeon
|March 5, 1998
PubMed

Insights

This case report highlights a rare instance of necrotizing soft-tissue infection caused by Aspergillus niger. Fungal pathogens should be considered in severe soft-tissue infections, even when uncommon.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Nonclostridial necrotizing soft-tissue infections (NNSTIs) are typically polymicrobial, often involving bacteria like streptococci or staphylococci.
  • Gram-negative enteric pathogens account for a smaller percentage of NNSTIs.

Observation:

  • A 46-year-old woman presented with bilateral lower extremity soft tissue infections.
  • Histopathology confirmed Aspergillus niger as the sole initial pathogen, causing extensive gangrenous necrosis and acute arteritis.

Findings:

  • Despite aggressive treatment including surgical debridement, allografts, and intravenous amphotericin B, the patient's condition worsened.
  • The patient ultimately succumbed to overwhelming fungal infection, underscoring the severity of this rare presentation.

Implications:

  • This case emphasizes the importance of including primary fungal pathogens in the differential diagnosis of severe soft-tissue infections.
  • Necrotizing fasciitis, regardless of etiology, carries a high mortality rate (approximately 60%).
  • Optimal treatment strategies for rare fungal soft-tissue infections require further investigation.

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