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Journal of Clinical Microbiology, May 1999, p. 1532-1535, Vol. 37, No. 5
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Femur Osteomyelitis Due to a Mixed Fungal Infection in a Previously Healthy Man

M. Cimerman,1 N. Gunde-Cimerman,2,* P. Zalar,2 and T. Perkovic3

Department of Traumatology1 and Institute of Pathology,3 University Medical Centre, and Department for Biotechnology and Industrial Mycology, National Institute of Chemistry,2 1000 Ljubljana, Slovenia

Received 7 August 1998/Returned for modification 22 September 1998/Accepted 29 January 1999

We describe a previously healthy, 22-year-old man who, after a closed fracture of the femur and subsequent operation, developed chronic osteomyelitis. Within a few days, infected bone fragments, bone, and wound drainage repeatedly yielded three different filamentous fungi: Aspergillus fumigatus, Aspergillus flavus, and Chalara ellisii. Histologic examination of the bone revealed septate hyphae. After sequential necrotomies of the femur and irrigation-suction drainage with added antimycotic therapy, the infection ceased and the fracture healed. This case is unique in that it is the only known instance in which a long bone was affected in an immunocompetent individual, with no evidence of any systemic infection, by a mixed population of two different Aspergillus spp. and the rare filamentous fungus C. ellisii. Environmental factors that could potentiate the infection include blood and edema fluid resulting from the surgical procedure and the presence of the osteosynthetic plate.


* Corresponding author. Mailing address: National Institute of Chemistry, Hajdrihova 19, 1000 Ljubljana, Slovenia. Phone: 386 61 176-03-33. Fax: 386 61 125-92-44. E-mail: nina.gunde.cimerman{at}ki.si.


Journal of Clinical Microbiology, May 1999, p. 1532-1535, Vol. 37, No. 5
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.



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