RESUMO
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.
Assuntos
Humanos , Anfotericina B , Articulação do Tornozelo , Tornozelo , Antibacterianos , Artrite , Artrite Infecciosa , Calcâneo , Candida , Fíbula , Fluconazol , Fungos , Articulações , Imageamento por Ressonância Magnética , Osteomielite , Fatores de Risco , Tálus , TíbiaRESUMO
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.
Assuntos
Humanos , Anfotericina B , Articulação do Tornozelo , Tornozelo , Antibacterianos , Artrite , Artrite Infecciosa , Calcâneo , Candida , Fíbula , Fluconazol , Fungos , Articulações , Imageamento por Ressonância Magnética , Osteomielite , Fatores de Risco , Tálus , TíbiaRESUMO
Candida arthritis is a rare joint infection. Its predisposing factors include prosthetic joint, intraarticular injection of corticosteroid and immunosuppression. Clinical diagnosis may be difficult because of the absence of specific signs and symptoms. Hence the presence of Candida species in synovial fluid should never be interpreted as laboratory contamination in patients with a risk factor, and therapy should be initiated promptly. We experienced a case of Candida arithritis secondary to repeated intraarticular corticosteroid injection in chronic tophaceous gout. We report the case with review of relevant literature.