title: Management of Candida guilliermondii joint infection in a dog.
abstract: BACKGROUND
  Candida spp. are dimorphic fungi in the family Cryptococcaceae. Infections with Candida spp. are usually rare conditions in dogs, but immunocompromised patients have a higher risk for developing invasive candidal infections.
  
  
  METHODS
  A 5-year-old male Boxer, positive to Leishmania infantum, was referred to the Veterinary Teaching Hospital of the Department of Veterinary Medicine, University of Perugia, Italy for examination of a non-weight bearing left hind limb lameness of a duration of at least 3 months. During this period, treatment involved systemic anti-inflammatory medications and intra-articular corticosteroid administration. On presentation, clinical examination and radiographic findings were suggestive of cranial cruciate ligament deficiency. To support this diagnosis a stifle arthroscopy was performed: it confirmed a partial rupture of cranial cruciate ligament. Samples culture of synovial fluid and membrane was routinely collected as well, and revealed Candida guilliermondii joint infection. Treatment for the C. guilliermondii joint infection involved systemic anti-fungal therapy, joint lavage and intra-articular administration of antifungal drugs. Lameness improved markedly during this treatment, but lameness did not resolve completely, probably due to cranial cruciate ligament deficiency. Tibial tuberosity advancement (TTA) was chosen in order to treat stifle instability and was performed 4 weeks following cessation of treatment of the C. guilliermondii joint infection. Six month after TTA the dog showed a completely recovery with no lameness.
  
  
  CONCLUSIONS
  To the authors' knowledge, this is the first case of Candida spp. joint infection reported in dogs. The cause of the progression of the joint C. guilliermondii infection remains unclear but it may be associated with leishmaniasis or intra-articular corticosteroid injections. Treatment with systemic and intra-articular anti-fungal therapies was successful. In the evaluation of hind limb lameness in a chronically immunocompromised dog, it would be advisable to consider also an intra-articular Candida spp.
authors.affiliation: Department of Veterinary Medicine, University of Perugia, Via S. Costanzo n.4, 06126, Perugia, PG, Italy.
authors.forename: Antonello
authors.initials: A
authors.lastname: Bufalari
authors.affiliation: Clinica Veterinaria Orvieto, Strada del Piano 9, 05018, Orvieto Scalo, TR, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Maggio
authors.affiliation: Department of Veterinary Medicine, University of Perugia, Via S. Costanzo n.4, 06126, Perugia, PG, Italy. giuliamoretti89@gmail.com.
authors.forename: Giulia
authors.initials: G
authors.lastname: Moretti
authors.affiliation: Department of Veterinary Medicine, University of Perugia, Via S. Costanzo n.4, 06126, Perugia, PG, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Crovace
authors.affiliation: Department of Veterinary Medicine, University of Perugia, Via S. Costanzo n.4, 06126, Perugia, PG, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Stefanetti
authors.affiliation: Institute of Infectious Diseases and Zoonoses, Faculty of Veterinary Medicine, Ludwig Maximilians Universität Munich, Munich, Germany.
authors.forename: Reinhard Konrad
authors.initials: RK
authors.lastname: Straubinger
authors.affiliation: Department of Veterinary Medicine, University of Perugia, Via S. Costanzo n.4, 06126, Perugia, PG, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Passamonti
mesh_terms: D000818:Animals; D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida; D002177:Candidiasis / Q000188:drug therapy / Q000628:therapy / Q000662:veterinary*; D004283:Dog Diseases / Q000188:drug therapy / Q000628:therapy*; D004285:Dogs; D016867:Immunocompromised Host; D007558:Italy; D007592:Joint Diseases / Q000188:drug therapy / Q000628:therapy / Q000662:veterinary*; D008297:Male; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents
keywords: Candida guilliermondii; Dog; Fungal arthritis; Fungal synovitis; Joint infectious