title: Case report: Eumycetoma and mycotic arthritis of the knee caused by Arthrographis kalrae.
abstract: A 33-year-old male presents following a penetrating injury to his right knee. Clinically he demonstrated pain, an effusion and fevers. At diagnostic arthroscopy, no microbiological growth was cultured. Delayed growth yielded the fungus Arthrographis kalrae. He was treated with a three-stage total knee arthroplasty. The first stage consisted of soft tissue debridement. The second stage involved femoral and tibial osteotomies and insertion of antifungal-impregnated cement spacers. Definitive total knee joint prosthesis were implanted during stage three. At 2 years follow up, he demonstrated a pain free range of motion and has returned to competitive tennis. To the authors' knowledge this is the first report implicating A. kalrae as an invasive pathogen of the knee in an immunocompetent host.
authors.affiliation: Department of Orthopaedic Surgery, Hollywood Private Hospital, Perth 6009, Australia ; Department of Orthopaedic Surgery, Sir Charles Gairdner Hospital, Perth 6009, Australia.
authors.forename: David Chen-Guan
authors.initials: DC
authors.lastname: Ong
authors.affiliation: Department of Orthopaedic Surgery, Hollywood Private Hospital, Perth 6009, Australia ; Department of Surgery, University of Western Australia, Perth 6009, Australia ; Department of Orthopaedic Surgery, Sir Charles Gairdner Hospital, Perth 6009, Australia.
authors.forename: Riaz
authors.initials: R
authors.lastname: Khan
authors.affiliation: Department of Orthopaedic Surgery, Hollywood Private Hospital, Perth 6009, Australia ; Department of Orthopaedic Surgery, Sir Charles Gairdner Hospital, Perth 6009, Australia.
authors.forename: Clay
authors.initials: C
authors.lastname: Golledge
authors.affiliation: Department of Orthopaedic Surgery, Hollywood Private Hospital, Perth 6009, Australia ; Department of Surgery, University of Western Australia, Perth 6009, Australia ; Department of Orthopaedic Surgery, Sir Charles Gairdner Hospital, Perth 6009, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Carey Smith
keywords: Infection; Mycetoma; Total knee replacement