title: Pseudallescheria boydii knee arthritis in a young immunocompetent adult two years after a compound patellar fracture.
abstract: Pseudallescheria boydii arthritis of the knee developed in a 32-year-old immunocompetent man 2 years after a compound patellar fracture contaminated with soil. No other potential portal of entry was identified, suggesting that the fungus remained latent for 2 years. Pseudallescheria arthritis often occurs after a prolonged latency period, causing minimal symptoms that contrast with the frequently severe radiological changes. Although this organism often shows limited sensitivity to most antifungal agents, our patient achieved a full recovery after surgical synovectomy and 6 months of itraconazole therapy (400 mg/ d). This case illustrates the importance of testing for fungi in patients with torpid arthritis, particularly when mild clinical symptoms contrast with severe bone and joint destruction.
authors.affiliation: Rheumatology Department, Hôtel-Dieu, CHU Nantes, France.
authors.forename: D
authors.initials: D
authors.lastname: Lavy
authors.forename: O
authors.initials: O
authors.lastname: Morin
authors.forename: G
authors.initials: G
authors.lastname: Venet
authors.forename: Y
authors.initials: Y
authors.lastname: Maugars
authors.forename: A
authors.initials: A
authors.lastname: Prost
authors.forename: J M
authors.initials: JM
authors.lastname: Berthelot
mesh_terms: D000328:Adult; D001170:Arthritis, Infectious / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D050723:Fractures, Bone / Q000150:complications* / Q000473:pathology; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D007718:Knee Injuries / Q000150:complications* / Q000473:pathology; D007719:Knee Joint / Q000382:microbiology* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008271:Mycetoma / Q000150:complications* / Q000473:pathology / Q000628:therapy; D010329:Patella / Q000293:injuries / Q000473:pathology; D011541:Pseudallescheria / Q000302:isolation & purification*; D000074402:Synovectomy; D016896:Treatment Outcome
chemical_list: D017964:Itraconazole