Fungal osteomyelitis after arthroscopic anterior cruciate ligament reconstruction: a case report with review of the literature.
Fungal osteomyelitis is a very rare complication after anterior cruciate ligament (ACL) reconstruction associated with catastrophic consequences. Herein, we present a case of such disastrous complication after ACL reconstruction. A 23-year-old man developed fever, swelling and pain of the affected knee from 18 days after arthroscopic ACL reconstruction. Therefore, he underwent arthroscopic debridement, removal of the graft and internal fixators, irrigation and suction drainage, successively. Negative results for serial bacterial cultures and smear examinations are obtained. However, computer tomography and X-ray examination showed massive bone destruction at 48 days after ACL reconstruction. As the first open debridement was performed at 50 days after ACL reconstruction, fungal infection was diagnosed based on finding Aspergillus hyphae in pathologic examination of the debrided bone sample. After the final debridement, a 12-cm bone loss in the distal femur was treated by Ilizarov's bone transport. The patient got solid arthrodesis of the affected knee without clinical infection at a year after the initial operation. In addition, a review of the literature regarding case reports of fungal osteomyelitis after ACL reconstruction is presented.
Orthopaedic Center of PLA, The 88th Hospital of PLA, Tai'an City, Shandong Province, China. sl88h@163.com
Lei
L
Sun
Lei
L
Zhang
Kai
K
Wang
Wei
W
Wang
Min
M
Tian
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects*; D000935:Antifungal Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D001182:Arthroscopy; D001228:Aspergillosis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D001230:Aspergillus / Q000302:isolation & purification; D003646:Debridement / Q000379:methods*; D006801:Humans; D007719:Knee Joint / Q000382:microbiology* / Q000601:surgery; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy
D000935:Antifungal Agents