Vol.22 No.6

Case Report

Fungal arthritis of the wrist caused by Candida parapsilosis during infliximab therapy for rheumatoid arthritis

Authors

Hideaki Miyamoto1 , Toshiki Miura1 , Euan Morita1 , Yutaka Morizaki1 , Kosuke Uehara1 , Takashi Ohe1 , Sakae Tanaka1

  • Department of Orthopaedic Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
Received:

16 November 2011

Accepted:

5 January 2012

Published online:

15 February 2012

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Abstract

A 60-year-old woman with rheumatoid arthritis, who had been treated with infliximab, presented with uncontrollable wrist arthritis. Fungal arthritis caused by Candida parapsilosis was confirmed by examining her aspirated joint fluid. Her infliximab therapy was interrupted, and antifungal therapy with fluconazole was started. After the fungal infection had been ameliorated, surgical debridement and arthrodesis of the wrist joint were conducted, and her symptoms completely resolved. Although fungal arthritis is rare, it should be considered as a differential diagnosis of exacerbated monoarthritis in patients treated with biological agents.

Key words

Candida parapsilosis - Infection - Infliximab - Fungal arthritis - Rheumatoid arthritis