Infect Chemother.  2008 Jun;40(3):170-174. 10.3947/ic.2008.40.3.170.

A Case of Septic Hip Arthritis Caused by Aspergillus fumigatus in a Liver Transplant Recipient

• Kim T
• Lee SR
• Cho OH
• Park KH
• Oh R
• Lee SO
• Kim YS
• Woo JH
• Kim MN
• Choi SH

• KMID: 1782291
• DOI: http://doi.org/10.3947/ic.2008.40.3.170

Abstract

Septic arthritis is an uncommon finding of invasive Aspergillosis. It can be caused by direct inoculation, post-surgical infection, and hematogenous spread. Articular aspergillosis often involves the knee. A 49-year-old man who received a liver transplant in China on two months ago, due to liver cirrhosis caused by hepatitis B virus was admitted because of left side hip pain. Hip MRI showed joint effusion and bony destruction of the left hip and acetabulum. Incision and drainage was done and Aspergillus fumigatus was isolated from the resected tissue. After eight weeks of amphotericin B therapy, total hip replacement arthroplasty was done. Oral itraconazole 400mg/day was prescribed for six months after operation. The patient is now doing well without physical restriction

Keyword

Aspergillus fumigatus; Infectious arthritis; Liver transplantation

MeSH Terms

Acetabulum
Amphotericin B
Arthritis
Arthritis, Infectious
Arthroplasty
Arthroplasty, Replacement, Hip
Aspergillosis
Aspergillus
Aspergillus fumigatus
China
Drainage
Hepatitis B virus
Hip
Humans
Itraconazole
Joints
Knee
Liver
Liver Cirrhosis
Liver Transplantation
Middle Aged
Transplants
Amphotericin B
Itraconazole

Figure

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  Figure 1 Hip MRI (A) T1 and (B) T2 image showing the joint effusion of the left hip, minimal bony destruction of the left acetabulum, and myositis involving the adductor longus, gluteus minimus and medius, and iliacus muscles.

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  Figure 2 Left hip excisional biopsy (A : Hematoxylin-eosin staining; original magnification×100, B : Hematoxylin-eosin staining; original magnification×400) showing fibrous tissue with chronic inflammation and calcifications.

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