Infect Chemother.  2005 Aug;37(4):242-245.

A Case of Candida Parapsilosis Ankle Arthritis after Intra-articular Steroid Injection

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea. paihj@hanyang.ac.kr
  • 2Department of Laboratory Medicine, College of Medicine, Hanyang University, Seoul, Korea.

Abstract

Candida species are uncommon cause of infectious arthritis. The increasing use of potent antibiotics, immunosuppressives, artificial joints, and especially the injection of steroid into the joints predispose to the fungal arthritis. Candida arthritis occurs by hematogenous dissemination or by direct inoculation of fungus into the joint cavity. Fifty three-year-old diabetic patient, who received intra-articular steroid injection into right ankle joint several times, was hospitalized because of aggravating ankle pain and swelling. Candida parapsilosis was isolated from the joint aspiration fluid and MRI findings were compatible with septic arthritis with osteomyelitis of distal tibia, distal fibula, talus, and calcaneus. The patient was successfully treated with 3 weeks of amphotericin B and 7 months of oral fluconazole. We report this case with review of pertinent literatures, emphasizing a high index of suspicion for the fungal infection in patients with predisposing risk factors.

Keyword

Candida arthritis; Steroid; Candida parapsilosis

MeSH Terms

Amphotericin B
Ankle Joint
Ankle*
Anti-Bacterial Agents
Arthritis*
Arthritis, Infectious
Calcaneus
Candida*
Fibula
Fluconazole
Fungi
Humans
Joints
Magnetic Resonance Imaging
Osteomyelitis
Risk Factors
Talus
Tibia
Amphotericin B
Anti-Bacterial Agents
Fluconazole
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