Aspergillus hip arthritis in COVID-19 era: Two case reports

Abstract

Corticosteroids have been a mainstay in the treatment protocols and guidelines of COVID-19. However, its use in high dosage or for extended duration renders patients immunocompromised after COVID-19 recovery, and thus, susceptible to secondary opportunistic infections. We report the two cases of septic hip arthritis due to Aspergillus species in corticosteroid immunosuppressed post-COVID-19 patients. One patient recovered successfully from the arthritis and subsequently underwent total hip arthroplasty with good outcome. The second patient presented late to us in a critical condition and had two comorbid conditions along with, due to which, in spite of all measures, could not be revived and succumbed to death. We highlight the issue of the rare cause of fungal hip arthritis in immunosuppressed post-COVID-19 patients and stress the necessity to remain vigilant and identify the causative organisms correctly, especially fungal pathogens in such susceptible populations in the present COVID-19 era.