can aspergillus terrus remain dormant in the knee from an open flap wound if medication was not properly given due to hospital error?

[wasspord71]

[GAtherton Administrator Fungal Infection Trust]

Infection by Aspergillus can be a slow process, it is very rare in this context and often difficult to detect. I would imagine correct procedure has been followed and antibiotics were given for by far the most likely types of infection. When a rare slow growing infection occurs it is undetectable at first - possibly for an extended period of time - and diagnosis can take days once such an infection is suspected. What is needed are fast, accurate tests for aspergillosis which currently do not exist - hence the need for specialist advice.

[wasspord71 in reply to GAtherton]

Okay, here's my story...on 10/12/2012 I was riding my bicycle on the side walk. This gentleman was exiting out of a food for less parking lot, apparently looking left, so make a right hand turn. Being on the side walk I Thought I had the right away, since he was stopped I proceeded not knowing he didnt see me. I was hit by his right side bumper, thrown out to the street, were he proceeded to pull over in the process ran over my left leg. There was a size of two half dollars open flap wound on my inner knee. Taken by ambulance to the E.R, X-rayed, with no broken bones or fractures, but a slightly severed ligament, and an open flap wound that required 46 stitches. The attending plastic surgeon was able to stick his pointer finger in the wound and able to move it all the way around as he was showing my dad as he pored iodine in it before stitching. I know this cause my brother and sister were there with me in the room as well. I have pictures before and after, as well as my hospital stay. I took pictures every day as i progressed. I was admitted the same day as the accident. Infection was evident by the 2nd or 3rd day. The doctor had to re-open the wound in order to take a deep wound culture, and pack in with some type of tube safety pinned to my knee. They started me on antibiotics, believe me they were the strongest ones they had, and they didnt work. My leg wasnt getting better. There was NO drainage at all, the infection was there, i had no elevated white blood cells, nor did i have a fever of any kind. I guess thats when they figured it was a fungus infection and an infectionus diease doctor came to see me. He too, took a deep wound culture, the results were aspergillus...now we have two positive deep wound cultures, two different doctor, on two different days for aspergillus, but we dont know the strain. I was in the hospital a total of 11 days from 10/12/2012 - 10/23/2012

( A week after I was discharged, is when my doctor called me up and said the strain was A. Terrus) Now They started me on V-Fend some where between the 19th and the 21st of Oct i believe, I was not to be discharged from the hospital unless i left with medication in my hand. Due to the high price of this medication, the hospital pharmacy only gave me three days worth to go home with. And applied an application for me offered by the phizer fund to receive the remaining of it by mail. So I was set, By error of the social worker handling my case, i never received the remaining of the medication. I was frantic, indulging myself on the internet trying to find out ANYTHING about this fungus that can ease my mind....but of course not, it just made things worse.

Now, I'm left with no option but to go to county and hope they will give me the medication. It's been five days since i've taken the v-fend.....I get to county, they dont believe me. As a matter of fact they wanted my infectious disease doctors number so they can tell him his diagnosis was wrong!!! Then prescribed me a medication i was given in the hospital that had no affect what so ever on the fungus.

I cried, as i was leaving i showed the nurse two prescription for 2 weeks of v-fend from two different doctors, from two different hospitals, she took them from me and came back with one week's worth of v=fend prescription. I was so happy, at least it was something. I just couldn't afford $2,000 dollars for 2 weeks, So now maybe you can get a clearer picture of my situation, I don't know all the medical terms but I was told i needed 20 days of this medication....lets just say i had 7 days of it in the hospital, 3 when discharged, that's only 10 days, a lapse of 5 days, before taking an additional 7....can the fungus lay dormant in my knee? And if I get the scar revised, will it spread like wildfire the way cancer does?

The mortality rate of patients is extremely high, like 66%, the only thing I have going for myself is I'm a very healthy 41 yr old female with no immunecomparable illnesses, yet somehow, some way managed to get a very rare form of aspergillus that we live with everyday. Is my situation really hard to believe....

Thanks for your time.....

Sara Carlin

[GAtherton Administrator Fungal Infection Trust]

Hello Sara

As you have not told me otherwise I will assume that your immune system is normal, you are not taking immunosuppressents, diabetic, haven't received a transplanted organ - in other words until your accident you were in good health with no medical intervention.

Under those circumstances your infection is unlikely to spread as your immune system will fight it off, but the provision of antifungals is a sensible precaution to help your immune system a little as rarely the fungus can get into places where the immune system is slightly weaker e.g. if you had an infection of your eye then antifungals are needed, if the infection is in your knee joint rather than the flesh surrounding your knee there have been a few cases of persisting infection.

The figures you have been reading for mortality apply to people who have little or no immune system as they are usually under treatment for cancer, or have received a transplant recently. Your immune system is fully functional as far as you have told me and that makes a huge difference. That said we need to be sure that your infection is cleared up and it sounds like the wound has healed so from what you say it sounds like that has been achieved - but the only way to be sure is to have it examined by your doctor.

If there is any further swelling, discomfort or any other reason you are worried go to see your doctor for an examination - perhaps it is worth mentioning to him/her anyway as the medication they was prescribed was denied to you by some sort of mix-up and he/she might be able to give you a letter verifying your claim.