Candida Arthritis in a Hemodialysis Patient

Park, Soo Yeon; Kwon, Yong Hwan; Kim, Seok Won; Jang, Dong Won; Jung, Yeon Oh; Shon, Min Soo; Cha, Ran Hui

doi:2014.18.2.93

Ann Geriatr Med Res > Volume 18(2); 2014 > Article

Case Report

Journal of the Korean Geriatrics Society 2014;18(2):93-97.
DOI: https://doi.org/10.4235/jkgs.2014.18.2.93 Published online June 30, 2014.

Candida Arthritis in a Hemodialysis Patient

Soo Yeon Park, Yong Hwan Kwon, Seok Won Kim, Dong Won Jang, Yeon Oh Jung, Min Soo Shon, Ran Hui Cha

¹Department of Internal Medicine, National Medical Center, Seoul, Korea. reginaprayer@gmail.com
²Department of Orthopedic Surgery, National Medical Center, Seoul, Korea.

혈액투석 환자에서 혈행을 통한 파종성 감염으로 발생한 칸디다 관절염 1예

박수연¹⦁권용환¹⦁김석원¹⦁장동원¹⦁정연오¹⦁손민수²⦁차란희¹

국립중앙의료원 내과¹, 정형외과²

Abstract

Candida is a rare cause of infectious arthritis, and it can be found in infants and immunocompromised patients. Patients with maintenance hemodialysis are prone to opportunistic infections because of altered immunity, and frequent exposures to health-care associated infections. Herein, we report a case of candida arthritis of right shoulder with preceding fungemia in patients with maintenance hemodialysis. The diagnosis is based on the isolation of Candida Tropicalis from blood and synovial fluids of the shoulder joint. The patient has received intravenous fluconazole and arthroscopic surgical debridement. We then changed the fluconazole into amphotericin B due to the abnormal signs in the liver function tests, although the fluconazole successfully controlled fungemia and arthritis. To the best of our knowledge, this is the first case of candida arthritis in patients with maintenance hemodialysis in South Korea.

Key Words: Arthritis, Candida, Fungemia, Hemodialysis