Hip Pelvis.  2015 Sep;27(3):196-200. 10.5371/hp.2015.27.3.196.

Aspergillus Septic Arthritis of the Hip in an Immunocompetent Middle-aged Female with Undiagnosed Recurrent Pulmonary Aspergillosis

• Yoon PW
• Song JH
• Yoon KS
• Chang JS
• Kim HJ
• Rhyu KH

• KMID: 2069152
• DOI: http://doi.org/10.5371/hp.2015.27.3.196

Abstract

We present a case of Aspergillus septic hip arthritis in an immunocompetent patient with undiagnosed recurrent pulmonary aspergillosis who underwent arthroscopic surgery. Biopsy specimens of synovium revealed fungal hyphae, confirming Aspergillus infection. Aspergillus septic hip arthritis can occur in immunocompetent patients, and arthroscopy can be a noninvasive surgical option in these cases.

Keyword

Hip; Aspergillus; Arthritis; Infectious; Arthroscopy

MeSH Terms

Arthritis
Arthritis, Infectious*
Arthroscopy
Aspergillus*
Biopsy
Female*
Hip*
Humans
Hyphae
Pulmonary Aspergillosis*
Synovial Membrane

Figure

• 

  Fig. 1 (A) Anteroposterior hip radiograph showing a slight narrowing of the joint space. (B) Magnetic resonance image showing marked joint effusion, and edematous changes of the bone marrow and muscles around the hip joint.

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  Fig. 2 (A) Arthroscopic view of a right hip through the anterolateral portal showing severe villous synovitis in the acetabular fossa. Synovial biopsy samples were taken through the posterolateral portal for culture and histological examination. (B) Arthroscopic view showing erosion of the acetabular cartilage and revealed subchondral bone. A: acetabular cartilage, FH: femoral head, L: labrum.

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  Fig. 3 Biopsy specimens reveal fungal hyphae in the fibrous tissue and chronic active inflammation with abscess formation. (A) Gomori methenamine silver stain, (B) periodic acid-Schiff stain; ×400.

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  Fig. 4 Anteroposterior hip radiographs before (A) and after (B) total hip arthroplasty.

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