Surgical Site Infection Caused by Aspergillus niger in an Immunocompetent Patient After Total Knee Arthroplasty Operation

Abstract

A 69-year-old immunocompetent female patient was admitted to emergency room with complaints of fever, cough, hemoptysis, pleuritic chest pain and dyspnea on the 5th week after implantation of bilateral knee prothesis. She had no other underlying disease. Pulmonary thromboembolism was detected, and the patient was hospitalized in pulmonary intensive care unit. She was intubated and anticoagulant therapy was started. Purulent drainage and necrosis of the surrounding soft tissues in both knees were noticed during the follow up. The pathological examination of the necrotic material demonstrated branching fungal hyphae, and the culture grew Aspergillus niger. Conventional amphotericin B was started along with surgical debridement. After 42 days of amphotericin B therapy the patient was discharged with full recovery. A. niger should be kept in mind while treating surgical site infections with tissue necrosis especially if there is no improvement despite appropriate antimicrobial therapy.

Keywords

• Aspergillus niger
• Surgical wound infection
• Arthroplasty