Refractory Post-Operative Wound Infection by Arthrographis Kalrae: A Case Report and Review of Literature

Abstract

Arthrographis kalrae (A. Kalrae) infections, although rare, have often demonstrated an extended clinical course. We report a case of refractory post-operative wound infection with A. Kalrae after radical soft tissue and femur resection following total femoral replacement. Identification of A. Kalrae was done based on detailed microscopic and phenotypic characteristics and biochemical tests. Additionally, it was confirmed with sequencing. Although antifungal therapy was started on the basis of the breakpoints observed, clinical failure was met. However, wound infection was subsequently controlled with extensive tissue debridement and a combination of antifungal drug therapy over a period of 33 weeks. The rarity of global data about such unusual fungal infections adds to diagnostic and therapeutic challenges.