title: Candida glabrata olecranon bursitis treated with bursectomy and intravenous caspofungin.
abstract: Orthopedic surgeons are becoming more involved in the care of patients with septic arthritis and bursitis caused by yeast species. This case report involves a middle-aged immunocompromised female who developed a Candida glabrata septic olecranon bursitis that developed after she received a corticosteroid injection in the olecranon bursa for presumed aseptic bursitis. Candida (Torulopsis) glabrata is the second most frequently isolated Candida species from the bloodstream in the United States. Increased use of fluconazole and other azole antifungal agents as a prophylactic treatment for recurrent Candida albicans infections in immunocompromised individuals is one reason why there appears to be increased resistance of C. glabrata and other nonalbicans Candida (NAC) species to fluconazole. In this patient, this infection was treated with surgery (bursectomy) and intravenous caspofungin, an echinocandin. This rare infectious etiology coupled with this intravenous antifungal treatment makes this case novel among cases of olecranon bursitis caused by yeasts.
authors.affiliation: Utah Orthopedic Specialists and Intermountain Medical Center, Salt Lake City, Utah 84107, USA. jskedrosmd@uosmd.com
authors.forename: John G
authors.initials: JG
authors.lastname: Skedros
authors.forename: Kendra E
authors.initials: KE
authors.lastname: Keenan
authors.forename: Joel D
authors.initials: JD
authors.lastname: Trachtenberg
mesh_terms: D061605:Administration, Intravenous; D000935:Antifungal Agents / Q000627:therapeutic use*; D002061:Bursa, Synovial / Q000601:surgery*; D002062:Bursitis / Q000276:immunology / Q000382:microbiology* / Q000628:therapy; D041221:Candida glabrata; D002177:Candidiasis / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D000077336:Caspofungin; D054714:Echinocandins / Q000627:therapeutic use*; D004551:Elbow Joint; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007270:Injections, Intra-Articular / Q000009:adverse effects; D055666:Lipopeptides; D008875:Middle Aged
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077336:Caspofungin