Complication of massive trauma by fungal infection and bone tuberculosis

Complication of massive trauma by fungal infection and bone tuberculosis:

Publication date: March 2020

Source: Medical Mycology Case Reports, Volume 27

Author(s): Fatehi Elzein, Nazik Mohammed, Maria Arafah, Ahmed Albarrag, Rabea Habib, Aqeel Faqehi

Abstract

We report a middle aged man who was admitted with severe necrotising fasciitis following a motor vehicle accident (MVA). Histopathology of the excised tissue suggested mucormycosis while a bone tissue culture revealed fully sensitive Mycobacterium tuberculosis. He received intravenous liposomal amphotericin B combined with multiple surgical debridements and ended with right shoulder disarticulation. In addition he completed a nine months course of anti-tuberculosis treatment. He remained stable one year following his admission.

We believe that trauma contributed to both conditions by direct inoculation of fungal spores and through immunological reactivation of old healed tuberculosis focus. This case highlights the importance of considering diagnosis of invasive fungal infections following MVA.