Abstract
Fungal infections are rare causes of acute surgical wound infections, but Candida is not an infrequent etiology in chronic wound infections. Trichophyton species is a common cause of tinea capitis but has not been reported as a cause of neurosurgical wound infection. We report a case of Trichophyton tonsurans causing a nonhealing surgical wound infection in a 14-year-old male after hemicraniectomy. His wound infection was notable for production of purulent exudate from the wound and lack of clinical improvement despite empiric treatment with multiple broad-spectrum antibiotics targeting typical bacterial causes of wound infection. Multiple wound cultures consistently grew Trichophyton fungus, and his wound infection clinically improved rapidly after starting terbinafine and discontinuing antibiotics.
Highlights
Trichophyton fungi are a common cause of tinea capitis but have not been reported as a cause of postsurgical scalp wound infection [1]
We report a 14-year-old male with a chronic wound infection after hemicraniectomy that was eventually determined to be caused by Trichophyton
He reported increasing pain along the incision while being treated with ceftazidime. ere were fluctuance and profound tenderness to palpation along the incision site (Figure 1(a)), and a new thick purulent discharge was expressible from the wound. ere were a few patchy areas of alopecia along the wound edges, which at the time were attributed to preoperative shaving, frequent wound cleaning, and removal of dressings and tape. e skin in the areas of alopecia was not scaly
Summary
Trichophyton fungi are a common cause of tinea capitis but have not been reported as a cause of postsurgical scalp wound infection [1]. 1. Introduction Trichophyton fungi are a common cause of tinea capitis but have not been reported as a cause of postsurgical scalp wound infection [1]. We report a 14-year-old male with a chronic wound infection after hemicraniectomy that was eventually determined to be caused by Trichophyton. A culture of purulent material expressed from the wound grew rare Pseudomonas aeruginosa.
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