Abstract:Fungal infections caused by Candida species have increased in incidence during the past two decades in England, North America and Europe. Candidal arthritis is rare in patients who are not intravenous drug users or are who not using a prostheses. We report the case of a 24-year-old man with acute lymphoid leukemia, who developed Candida tropicalis arthritis during an aplastic period after chemotherapy. This is the eighth case described in the literature of C. tropicalis causing arthritis without intra-articula… Show more
“…In our study, one adult with septic arthritis of the hip had decreased perfusion of the femoral epiphysis on MRI, and Candida tropicalis grew on culture of aspirate. C. tropicalis arthritis has been found in patients with hematologic malignant disease, and septic arthritis can be the first sign of C. tropicalis infection [31][32][33][34]. Our patient later proved to have hemophagocytic lymphohistiocytosis.…”
OBJECTIVE. The purpose of this study was to identify differences in the MRI findings of septic arthritis and transient synovitis in patients with nontraumatic acute hip pain and hip effusion.MATERIALS AND METHODS. The MRI findings in nine patients with septic arthritis and 11 with transient synovitis were reviewed retrospectively. This study was approved by our institutional review board. The diagnoses were based on findings at physical examination, laboratory studies, and joint aspiration and bacteriologic study. The MRI findings were analyzed with emphasis on the grade of joint effusion, alterations in signal intensity in the soft tissues and bone marrow, and the presence of decreased perfusion at the femoral head.RESULTS. Low signal intensity on fat-suppressed gadolinium-enhanced T1-weighted coronal MRI suggesting decreased perfusion at the femoral head of the affected hip joint was seen in eight of nine patients with septic arthritis and in two of 11 patients with transient synovitis. Statistically reliable differences (p = 0.005) were found between the two groups. Alterations in signal intensity in the bone marrow were seen in three patients with septic arthritis but in none of the patients with transient synovitis. Decreased perfusion on fat-suppressed gadolinium-enhanced coronal T1-weighted MRI was seen in the six patients with septic arthritis who did not have alterations in signal intensity involving the bone marrow.CONCLUSION. Decreased perfusion at the femoral epiphysis on fat-suppressed gadolinium-enhanced coronal T1-weighted MRI is useful for differentiating septic arthritis from transient synovitis.
“…In our study, one adult with septic arthritis of the hip had decreased perfusion of the femoral epiphysis on MRI, and Candida tropicalis grew on culture of aspirate. C. tropicalis arthritis has been found in patients with hematologic malignant disease, and septic arthritis can be the first sign of C. tropicalis infection [31][32][33][34]. Our patient later proved to have hemophagocytic lymphohistiocytosis.…”
OBJECTIVE. The purpose of this study was to identify differences in the MRI findings of septic arthritis and transient synovitis in patients with nontraumatic acute hip pain and hip effusion.MATERIALS AND METHODS. The MRI findings in nine patients with septic arthritis and 11 with transient synovitis were reviewed retrospectively. This study was approved by our institutional review board. The diagnoses were based on findings at physical examination, laboratory studies, and joint aspiration and bacteriologic study. The MRI findings were analyzed with emphasis on the grade of joint effusion, alterations in signal intensity in the soft tissues and bone marrow, and the presence of decreased perfusion at the femoral head.RESULTS. Low signal intensity on fat-suppressed gadolinium-enhanced T1-weighted coronal MRI suggesting decreased perfusion at the femoral head of the affected hip joint was seen in eight of nine patients with septic arthritis and in two of 11 patients with transient synovitis. Statistically reliable differences (p = 0.005) were found between the two groups. Alterations in signal intensity in the bone marrow were seen in three patients with septic arthritis but in none of the patients with transient synovitis. Decreased perfusion on fat-suppressed gadolinium-enhanced coronal T1-weighted MRI was seen in the six patients with septic arthritis who did not have alterations in signal intensity involving the bone marrow.CONCLUSION. Decreased perfusion at the femoral epiphysis on fat-suppressed gadolinium-enhanced coronal T1-weighted MRI is useful for differentiating septic arthritis from transient synovitis.
“…Articular structures can be affected by mycotic infections through direct inoculation, contiguous spread, or hematogenous dissemination [ 1 - 4 ]. Of the various Candida species, Candida albicans is most commonly associated with fungal arthritis, especially in immunocompromized individuals [ 4 - 7 ]. Typically infection predominates in large weight-bearing joints, most often the knee [ 8 ].…”
Introduction Synovial cells are potential sources of inflammatory mediators in bacterial-induced arthritis but their involvement in the inflammatory response to Candida albicansinduced septic arthritis is largely unknown.
“…Despite its toxicity, AmB was the initial drug used in 68% cases of Candida arthritis [5,8,13] and its good penetration into the synovial fluid has been shown when given intravenously [15]. Farrell et al [15] concluded that adequate synovial fluid concentration of AmB was achieved during systemic therapy and intra-articular administration was ordinarily unnecessary.…”
Section: Discussionmentioning
confidence: 99%
“…Fungal arthritis is a relatively rare complication that occurs in neutropenic patients with hematological disease and cancer especially those receiving prophylactic FCZ and broad-spectrum antibiotics. C. albicans has been reported to be the most common species causing fungal arthritis [3] followed by Candida tropicalis (C. tropicalis) [4][5][6][7][8][9], while C. krusei still remains very rare [9][10][11].…”
Fungal arthritis is a relatively rare complication, which occurs in patients with hematological disease and cancer. Recently non-albicans Candida species have emerged as clinically important agents; however, Candida krusei (C. krusei) arthritis is still rare. We report a 6-year-old boy who developed C. krusei arthritis associated with acute lymphoblastic leukemia. He was given oral fluconazole and broad-spectrum antibiotics prophylactically, but nevertheless, he developed fungemia with C. krusei and subsequently developed arthritis in his right hip. He was successfully treated with liposomal amphotericin B and micafungin combined with surgical drainage. This is the youngest case with C. krusei arthritis.
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