Abstract
A 79-year-old male with acute myelogenous leukemia developed acute right knee arthritis during admission, after the use of broad-spectrum antibiotics before chemotherapy. The initial synovial fluid sample appeared to be mildly inflammatory with a low white cell count. The fungal septic arthritis was not diagnosed until Candida tropicalis, a rare species of Candida, was isolated in the synovial fluid. Although fluconazole is effective in treating the microorganism, the untreated leukemia rendered the infection incurable and led to the growth of fluconazole-resistant Candida krusei. We reported the unusual case of fungal arthritis and reviewed the literature.
References
Cuende E, Barbadillo C, E-Mazzucchelli R, Isasi C, Trujillo A, Andreu JL (1993) Candida arthritis in adult patients who are not intravenous drug addicts: report of three cases and review of the literature. Semin Arthritis Rheum 22:224–241
Fainstein V, Gilmore C, Hopfer RL, Maksymiuk A, Bodey GP (1982) Septic arthritis due to Candida species in patients with cancer: report of five cases and review of the literature. Rev Infect Dis 4:78–85
Nguyen VQ, Penn RL (1987) Candida krusei infectious arthritis. A rare complication of neutropenia. Am J Med 83:963–965
Weers-Pothoff G, Havermans JF, Kamphuis J, Sinnige HA, Meis JF (1997) Candida tropicalis arthritis in a patient with acute myeloid leukemia successfully treated with fluconazole: case report and review of the literature. Infection 25:109–111
Karsh J (1988) Candida arthritis. In: Spinoza L, Goldemberg DL, Arnett FC et al (eds) Infection in the rheumatic diseases. Grune & Stratton, Orlando, FL, pp 189–197
Sim JP, Kho BC, Liu HS, Yung R, Chan JC (2005) Candida tropicalis arthritis of the knee in a patient with acute lymphoblastic leukaemia: successful treatment with caspofungin. Hong Kong Med J 11:120–123
Poplack DG, Jacobs SA (1975) Candida arthritis treated with amphotericin B. J Pediatr 87:989–990
Mandel DR, Segal AM, Wysenbeek AJ, Calabrese LH (1984) Two unusual strains of Candida arthritis. Am J Med Sci 288:25–27
Leung AY, Chim CS, Ho PL, Cheng VC, Yuen KY, Lie AK et al (2002) Candida tropicalis fungaemia in adult patients with haematological malignancies: clinical features and risk factors. J Hosp Infect 50:316–319
Abi-Said D, Anaissie E, Uzun O, Raad I, Pinzcowski H, Vartivarian S (1997) The epidemiology of hematogenous candidiasis caused by different Candida species. Clin Infect Dis 24:1122–1128
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wang, HP., Yen, YF., Chen, WS. et al. An unusual case of Candida tropicalis and Candida krusei arthritis in a patient with acute myelogenous leukemia before chemotherapy. Clin Rheumatol 26, 1195–1197 (2007). https://doi.org/10.1007/s10067-006-0336-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-006-0336-9