Candida Arthritis after Arthroscopic Arthroplasty in a Patient without Predisposing Factors

Abstract

Because candidiasis is usually associated with immunosuppression, candida arthritis in an immunocompetent patient is rare. The symptoms of candidiasis are similar to bacterial infections, tuberculosis, and autoimmune diseases. In our patient with no predisposing factors, candida arthritis was initially excluded because the probability of occurrence was low. The patient had no leukocytosis, the acid-fast bacteria (AFB) stain was negative, and the autoimmune antibody screen was negative. After Candida parapsilosis was cultured in the synovial fluid, the patient was treated with amphotericin B (0.7 mg/kg/day) and oral fluconazole (400 mg/day). The treatment was successful and there were no side effects of the medications.

Keywords: Candida arthritis; arthroplasty..

Fig. (1)

Radiographs of both knee shows mottled appearance of distal femur and proximal tibia and also asymmetric joint space narrowing.

Fig. (2)

Gadolinium enhanced T₁ weight MRI of right knee shows large amount of joint effusion and enhanced synovium indicating inflammatory arthritis.