Fatal Aspergillus fumigatus Myositis in an immunocompetent patient

Eur J Clin Microbiol Infect Dis. 2001 Nov;20(11):810-3. doi: 10.1007/s100960100607.

Abstract

A 69-year old farmer developed Aspergillus myositis in the right psoas and paravertebral muscles extending to the retroperitoneum and the fifth lumbar vertebra. The infection appeared after two local instillations of steroid for back pain. Although the patient was not immunocompromised, surgical drainage and antifungal therapy failed to cure him; he died of a bacterial pulmonary superinfection while cultures of the abscess drainage fluid grew Aspergillus. The likely portal of entry in this patient was direct inoculation during infiltration of the steroid; the steroid probably caused a local impairment in host defenses. Only six cases of Aspergillus myositis have been reported previously. All of them occurred in severely immunosuppressed patients and the outcome was fatal in all cases.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abscess / diagnosis
  • Abscess / microbiology*
  • Abscess / therapy
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Aspergillosis / diagnosis*
  • Aspergillosis / drug therapy
  • Aspergillosis / etiology
  • Aspergillosis / immunology
  • Aspergillus fumigatus / isolation & purification*
  • Back Pain / diagnosis
  • Back Pain / drug therapy
  • Drainage / methods
  • Fatal Outcome
  • Humans
  • Immunocompetence*
  • Injections, Intralesional / adverse effects*
  • Male
  • Myositis / diagnosis
  • Myositis / etiology
  • Myositis / microbiology*
  • Risk Assessment
  • Steroids / administration & dosage*
  • Steroids / adverse effects
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents
  • Steroids