A Case of Fungal Arthritis by Blastoschizomyces capitatus / 감염

ABSTRACT

Blastoschizomyces capitatus (formerly Trichosporon capitatus) causes piedra and sometimes invasive infections in immunocompromised hosts. Arthritis by B. capitatus in a previously healthy person has not been reported. Herein we experienced a case of pyogenic arthritis of the knee joint in a farmer and reported the clinical course and literature review. A 68-year old man was adimitted because of swelling and painful left knee joint. Under the impression of septic arthritis of the left knee, empiric antibiotic treatment was initially done. On fifth admission day, B. capitatus was reported in joint fluid culture for the first time. Arthroscopic finding revealed infected synovium and pus-like fluid collection on patello-femoral joint. Amphotericin B was tried but discontinued due to hypokalemia after 7 day use. Secondary arthroscope showed subchondral destruction on medial femoral condyle and medial tibial plateau. Eight week treatment with parenteral fluconazole (daily 100 mg) and oral ketoconazole (200 mg daily) resulted in complete resolution of the patient's symptom. But knee joint ankylosis was remained.