title: Fungal arthritis of the wrist caused by Candida parapsilosis during infliximab therapy for rheumatoid arthritis.
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.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyamoto
authors.forename: Toshiki
authors.initials: T
authors.lastname: Miura
authors.forename: Euan
authors.initials: E
authors.lastname: Morita
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Morizaki
authors.forename: Kosuke
authors.initials: K
authors.lastname: Uehara
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohe
authors.forename: Sakae
authors.initials: S
authors.lastname: Tanaka
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002175:Candida / Q000302:isolation & purification*; D002177:Candidiasis / Q000188:drug therapy* / Q000601:surgery; D003646:Debridement; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D000069285:Infliximab; D008875:Middle Aged; D014955:Wrist Joint / Q000382:microbiology* / Q000601:surgery
chemical_list: D000911:Antibodies, Monoclonal; D000935:Antifungal Agents; D018501:Antirheumatic Agents; D015725:Fluconazole; D000069285:Infliximab