Journal List > Infect Chemother > v.44(6) > 1035201

TOOLS
Song, Oh, Kim, Kim, Ahn, Jeong, Ku, Kim, Kim, Han, Choi, Kim, Song, and Kim: Multicystic Mass Infection in the Subcutaneous Tissue around Joint Developed by Aspergillus in a Liver Transplant Patient
Case Report
Infection & Chemotherapy

Infection & Chemotherapy 2012; 44(6): 465-468.

Published online: 31 December 2012

DOI: https://doi.org/10.3947/ic.2012.44.6.465

Multicystic Mass Infection in the Subcutaneous Tissue around Joint Developed by Aspergillus in a Liver Transplant Patient

Je Eun Song1, Dong Hyun Oh1, Min Hyung Kim1, Yong Chan Kim1, Jin Young Ahn1, Su Jin Jeong1, Nam Su Ku1, Hye Won Kim1, 2, Sun Bean Kim1, 2, Sang Hoon Han1, 2, Jun Yong Choi1, 2, Chang Oh Kim1, 2, Young Goo Song1, 2, June Myung Kim1, 2

1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

2AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Correspondence to Sang Hoon Han, M.D. Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: +82-2-2228-1991, Fax: +82-2-393-6884, shhan74@yuhs.ac

Received 19 March 2012       Revised 12 June 2012       Accepted 28 August 2012

Copyright © 2012 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Invasive aspergillosis can be occured in immune-compromised patients with hematopoietic stem cell transplantation, solid organ transplantation and prolonged neutropenia. The major area of invasive aspergillosis involves the sinopulmonary tract but can occur around the joint areas rarely. A 72-year-old man, who had received a liver transplant 6 years earlier, presented with a mass lesion around the right knee joint that developed 3 year earlier. Knee MRI revealed a multicystic subcutaneous mass around the knee joint. An excision was performed, and many fungal hyphae that were morphologically most consistent with Aspergillus spp. were observed in tissue. After amphotericin B therapy for 2 weeks, the patient did not show any evidence of a recurrence of invasive aspergillosis for 15 months. As Aspergillus spp. can cause a range of infections in solid organ transplants, invasive aspergillosis must be considered in patients with a recurrent cystic mass lesion.

Keywords: Aspergillus, Liver transplantation, Cysts

Figures and Tables

Figure 1
Findings of the right lower extremity MRI in (A) coronal view (B) sagittal view show the 2.7×1.9×3.1 cm sized multicystic mass at the anteromedial aspect of the proximal lower leg (Arrow).
ic-44-465-g001
Figure 2
Pathologic examination of the excisional mass (A) D-PAS and (B) GMS stain showing acute suppurative inflammation with giant cells (arrow) and the presence of many fungal hyphae (arrow, that were morphologically most consistent with Aspergillus spp.
ic-44-465-g002
Table 1
Clinical Characteristics of Articular Aspergillosis in 10 Immunocompromised Patients
ic-44-465-i001

aN/D, no data or not available to access to data

Modified from Golmia et al [2]

References

1. Segal BH. Aspergillosis. N Engl J Med. 2009. 360:1870–1884.
crossref
2. Golmia R, Bello I, Marra A, Hamerschlak N, Osawa A, Scheinberg M. Aspergillus fumigatus joint infection: a review. Semin Arthritis Rheum. 2011. 40:580–584.
crossref
3. Kim T, Lee SR, Cho OH, Park KH, Oh R, Lee SO, Kim YS, Woo JH, Kim MN, Choi SH. A case of septic hip arthritis caused by aspergillus fumigatus in a liver transplantation recipient. Infect Chemother. 2008. 40:170–174.
crossref
4. Austin KS, Testa NN, Luntz RK, Greene JB, Smiles S. Aspergillus infection of total knee arthroplasty presenting as a popliteal cyst. Case report and review of the literature. J Arthroplasty. 1992. 7:311–314.
crossref
5. Upton A, Kirby KA, Carpenter P, Boeckh M, Marr KA. Invasive aspergillosis following hematopoietic cell transplantation: outcomes and prognostic factors associated with mortality. Clin Infect Dis. 2007. 44:531–540.
crossref
6. Pfaller MA, Diekema DJ. Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev. 2007. 20:133–163.
crossref
7. Salman N, Törün SH, Budan B, Somer A. Invasive aspergillosis in hematopoietic stem cell and solid organ transplantation. Expert Rev Anti Infect Ther. 2011. 9:307–315.
crossref
TOOLS
Similar articles