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[The radiological findings in septic Candida arthritis (author's transl)]
Abstract:
There are very few reports of bacteriologically proven Candida arthritis. With the increasing number of cases of immune deficient infants being treated now, one must expect an increase in frequency of fungus infections, including Candida arthritis. We have observed three cases of fungus arthritis in infants with reduced resistance. The radiological changes were indistinguishable from bacterial arthritides. During the acute phase the accumulation of pus and exudate showed widening of the joint space on the radiograph, with increase of the peri-articular soft tissues. In two patients a central bone abscess was seen in the metaphysis which later showed a sclerotic margin. In one patient with a gonarthritis there was complete healing, but in two fungus infections of the hip there was persistent late demage. One patient developed a deformed hip joint with subluxation, which had to be treated surgically after ineffective medical treatment. In the other case there was considerable flattening of the femoral head.
Insights
Candida arthritis is rare but may increase in immunocompromised infants. Radiological findings mimic bacterial arthritis, with potential for long-term joint damage.
Area of Science:
- Pediatric Rheumatology
- Infectious Diseases
- Medical Imaging
Background:
- Reports of bacteriologically proven Candida arthritis are scarce.
- Increasing numbers of immunocompromised infants necessitate vigilance for opportunistic infections like Candida arthritis.
Purpose of the Study:
- To report on three cases of fungus arthritis in infants with reduced resistance.
- To describe the radiological findings and clinical outcomes of Candida arthritis in infants.
Main Methods:
- Retrospective review of three infant cases with fungus arthritis.
- Analysis of radiological changes during the acute phase and long-term follow-up.
- Correlation of imaging findings with clinical presentation and treatment outcomes.
Main Results:
- Radiological changes were indistinguishable from bacterial arthritides, including joint space widening and soft tissue swelling.
- Bone abscesses in the metaphysis were observed in two patients.
- While one case of gonarthritis healed completely, two hip infections resulted in persistent damage, including subluxation and femoral head flattening.
Conclusions:
- Candida arthritis, though rare, should be considered in infants with reduced resistance, especially with non-specific radiological findings.
- Early diagnosis and treatment are crucial to prevent long-term sequelae, which can be severe and require surgical intervention.