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Suppurative Arthritis Induced by Scedosporium apiospermum and Mycobacterium fortuitum: a Case Report.

BACKGROUND
Suppurative arthritis induced by Scedosporium apiospermum (S. apiospermum) or Mycobacterium fortuitum (MF) was rare, and even more so when caused by a mixed infection of the two. In this paper, we report the rare case of suppurative arthritis induced by S. apiospermum and MF.


METHODS
A 46-year-old patient whose left knee was accidentally injured by a rotary tiller. His left knee joint was clearly swollen although debridement and suturing had been performed twice at a local hospital. Bacterial culture result was MF and S. apiospermum after admission. Definitive therapy (debridement combined with treatment using three antibiotics) was initiated.


RESULTS
Although the fungus reappeared when he tried to discontinue the drug, after the third debridement combined with treatment using three antibiotics for 8 months, the infection was controlled and did not recur.


CONCLUSIONS
This demonstrates that early bacteriological examination is essential. Treatment of fungus generally requires a long course. However, course of medication should be related to the patient's specific conditions and the implementation of the operation.