Fracture treatment in the setting of cutaneous aspergillosis: a case report

The authors present the case of a patient who developed an Aspergillosis flavus (A flavus) superficial cutaneous infection which was identified at the time of cast removal, 2 weeks after immobilization of a closed distal third humerus fracture. Clinical and microbiological findings, as well as the treatment of this patient, are reported. An otherwise healthy 27-year-old male presented to the orthopaedic surgery clinic 2 weeks after a closed distal humerus fracture, which was initially immobilized with a functional removable brace. Upon cast removal, the patient was noted to have significant brown hyperkeratotic patches and plaques, studded with pustules in an annular configuration on his left posterior and lateral arm. Fungal culture later grew A flavus. The patient was started on both oral and topical antifungals and operative management of the displaced fracture was delayed until skin lesions resolved. Once clinical examination and negative repeat bedside potassium hydroxide were confirmed, open reduction and internal fixation was performed. The fracture healed uneventfully, and the patient did not develop any signs or symptoms of postoperative infection.