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A Case of Candida Parapsilosis Ankle Arthritis after Intra-articular Steroid Injection
Seung-Min Cheon, M.D.1, Ho-Yong Park, M.D.1, Ji-Yong Moon, M.D.1, Jai-Hoon Yoon, M.D.1 Won Moon, M.D.1, Sang-Mo Hong, M.D.1, Joong-Ho Bae, M.D.1, Je Lee, M.D.1 Tae-Yeal Choi, M.D.2, and Hyunjoo Pai, M.D.1
1Department of Internal Medicine, 2Laboratory Medicine, College of Medicine, Hanyang University, Seoul, Korea
Vol.37 Num.4 (p242~245)
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.
Keywords : Candida arthritis, Steroid, Candida parapsilosis