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Diagnostic difficulty identifying Apophysomyces trapeziformis septic arthritis in a patient with multiple myeloma
- Source :
- JMM Case Reports
- Publication Year :
- 2016
- Publisher :
- Microbiology Society, 2016.
-
Abstract
- Introduction: Mucormycosis is a rare fungal infection, but can cause substantial morbidity and mortality in both immunocompromised and immunocompetent patients. Apophysomyces is a mucormycetes species ubiquitous in nature, particularly in soil, decaying wood and other organic matter. Apophysomyces 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 Apophysomyces trapeziformis 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 A. trapeziformis. 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.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
mould
medicine.medical_specialty
Posaconazole
methenamine silver staining
Fungal Infections
medicine.drug_class
030106 microbiology
Antibiotics
Case Report
Mycology
Microbiology
mucormycosis
03 medical and health sciences
Medical Mycology
Amphotericin B
amputation
Human Pathogenic Fungi
medicine
Bone
septic arthritis
Multiple myeloma
biology
business.industry
Mucormycosis
medicine.disease
biology.organism_classification
Dermatology
Apophysomyces
Immunology
Clinical Mycology
Septic arthritis
business
Penetrating trauma
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 20533721
- Volume :
- 3
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- JMM Case Reports
- Accession number :
- edsair.doi.dedup.....91389361fe33f3cd083b219a4f506bcf