Limits...
A case of fungal arthritis caused by Hansenula anomala.

Choi SW, Lee TJ, Kim MK, Lee M, Jung JH - Clin Orthop Surg (2010)

Bottom Line: Consequently, knee joint aspiration was performed again, which identified fungal arthritis caused by H. anomala.It was treated successfully with amphotericin B and fluconazole.When treating arthritis patients with diabetes, it is important to consider the possibility of septic arthritis by H. anomala and provide the appropriate treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Cheju National University Hospital, Jeju, Korea.

ABSTRACT
Hansenula anomala (H. anomaly) is part of the normal flora in the alimentary tract and throat. It has been reported to be an organism causing opportunistic infections in immunocompromised patients. However, cases of fungal arthritis caused by H. anomala are rare. We encountered a case of H. anomala arthritis in a 70-year-old man who was treated with an empirical antibiotic treatment and surgery under the impression of septic arthritis. However, the patient did not improve after antibiotic therapy and surgery. Consequently, knee joint aspiration was performed again, which identified fungal arthritis caused by H. anomala. It was treated successfully with amphotericin B and fluconazole. When treating arthritis patients with diabetes, it is important to consider the possibility of septic arthritis by H. anomala and provide the appropriate treatment.

Show MeSH

Related in: MedlinePlus

Anteroposterior and lateral roentgenograms show mild joint space narrowing but no definite abnormality.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2824097&req=5

Figure 1: Anteroposterior and lateral roentgenograms show mild joint space narrowing but no definite abnormality.

Mentions: A 70-year-old male was admitted to our hospital primarily due to pain and swelling of the left knee that had been present for more than 1 month. He had no specific diseases except for diabetes and was transferred to our institution due to signs of inflammation observed in a fine needle aspiration biopsy performed at a nearby hospital more than 1 month prior to admission. Based on the history of the illness, oral medication was administered to treat the type II diabetes. The patient's vital signs at the time of admission were as follows: blood pressure 130/80 mmHg, pulse rate 95 bpm, respiratory rate 20 breaths/min, and temperature 36.8℃. In the physical examination, severe swelling of the left knee, minor flare, and local thermal sensations were found as well as passive movements caused severe pain. In the blood test performed upon admission, the white blood cell count, hemoglobin, platelet count, erythrocyte sedimentation rate and C-reactive protein was 18,500/mm3, 11 g/dL, 286,000/mm3, 34 mm/hr and 2.4 mg/dL, respectively. The fine needle aspiration biopsy revealed reddish-brown exudates. Joint fluid analysis showed a red blood cell count, white blood cell count and a glucose level of 4,400/mm3, 84,560/mm3 (neutrophil 80%, lymphocyte 10%, and monocyte 10%) and 228 mg/dL, respectively, and no nodes were observed. No microorganisms were found in the bacterial culture. On the plain radiographs, minor joint space narrowing was observed in the medial compartment of the left knee but no abnormal findings were noted (Fig. 1). A bone scan showed increased uptake in the left knee (Fig. 2).


A case of fungal arthritis caused by Hansenula anomala.

Choi SW, Lee TJ, Kim MK, Lee M, Jung JH - Clin Orthop Surg (2010)

Anteroposterior and lateral roentgenograms show mild joint space narrowing but no definite abnormality.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2824097&req=5

Figure 1: Anteroposterior and lateral roentgenograms show mild joint space narrowing but no definite abnormality.
Mentions: A 70-year-old male was admitted to our hospital primarily due to pain and swelling of the left knee that had been present for more than 1 month. He had no specific diseases except for diabetes and was transferred to our institution due to signs of inflammation observed in a fine needle aspiration biopsy performed at a nearby hospital more than 1 month prior to admission. Based on the history of the illness, oral medication was administered to treat the type II diabetes. The patient's vital signs at the time of admission were as follows: blood pressure 130/80 mmHg, pulse rate 95 bpm, respiratory rate 20 breaths/min, and temperature 36.8℃. In the physical examination, severe swelling of the left knee, minor flare, and local thermal sensations were found as well as passive movements caused severe pain. In the blood test performed upon admission, the white blood cell count, hemoglobin, platelet count, erythrocyte sedimentation rate and C-reactive protein was 18,500/mm3, 11 g/dL, 286,000/mm3, 34 mm/hr and 2.4 mg/dL, respectively. The fine needle aspiration biopsy revealed reddish-brown exudates. Joint fluid analysis showed a red blood cell count, white blood cell count and a glucose level of 4,400/mm3, 84,560/mm3 (neutrophil 80%, lymphocyte 10%, and monocyte 10%) and 228 mg/dL, respectively, and no nodes were observed. No microorganisms were found in the bacterial culture. On the plain radiographs, minor joint space narrowing was observed in the medial compartment of the left knee but no abnormal findings were noted (Fig. 1). A bone scan showed increased uptake in the left knee (Fig. 2).

Bottom Line: Consequently, knee joint aspiration was performed again, which identified fungal arthritis caused by H. anomala.It was treated successfully with amphotericin B and fluconazole.When treating arthritis patients with diabetes, it is important to consider the possibility of septic arthritis by H. anomala and provide the appropriate treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Cheju National University Hospital, Jeju, Korea.

ABSTRACT
Hansenula anomala (H. anomaly) is part of the normal flora in the alimentary tract and throat. It has been reported to be an organism causing opportunistic infections in immunocompromised patients. However, cases of fungal arthritis caused by H. anomala are rare. We encountered a case of H. anomala arthritis in a 70-year-old man who was treated with an empirical antibiotic treatment and surgery under the impression of septic arthritis. However, the patient did not improve after antibiotic therapy and surgery. Consequently, knee joint aspiration was performed again, which identified fungal arthritis caused by H. anomala. It was treated successfully with amphotericin B and fluconazole. When treating arthritis patients with diabetes, it is important to consider the possibility of septic arthritis by H. anomala and provide the appropriate treatment.

Show MeSH
Related in: MedlinePlus