Aspergillus as a rare cause of non-healing traumatic breast wound

Introduction: Aspergillus is an opportunistic fungal infection in immunocompromised hosts with a very rare occurrence in breast tissue. Case Report: We report a case of Aspergillus flavus, identified within a non-healing ulcer in the breast of an immunocompromised host. The patient was a 63-year old lady with diabetes mellitus and severe rheumatoid arthritis requiring oral prednisolone therapy. She had developed a pressure ulcer on her right breast secondary to an upper extremity cast placed for conservative management of a humerus fracture. This pressure ulcer failed to improve despite multiple debridements, local wound care and antibiotic treatment. Tissue biopsy from the debridement specimen revealed fungal hyphae without evidence of malignancy. Formal fungal cultures confirmed this to be Aspergillus flavus. She was started on oral Itraconazole along with local wound care. She later succumbed to gram negative sepsis and Disseminated intravascular coagulation (DIC). Extensive literature search to identify causes of non-healing traumatic breast wounds revealed a few case reports only. Conclusion: Aspergillus can present with extensive soft tissue or breast involvement in immune suppressed individuals and should be considered in patients with a non-healing breast wound with a high index of suspicion.