Primary traumatic cutaneous aspergillosis of the hand caused by Aspergillus terreus following a mould-contaminated penetrating injury.

A 39-year-old man with poorly controlled diabetes mellitus developed progressive hand infection after a mould-contaminated penetrating steel injury. Operative debridement revealed sloughy infected tissue, and cultures from pus, tissue, and slough all yielded Aspergillus terreus. There was no evidence of disseminated infection. He improved with surgical source control, voriconazole therapy, and optimisation of glycaemic control. This case highlights traumatic inoculation as an important mechanism of primary cutaneous aspergillosis and the importance of early fungal-directed therapy.