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[Slow onset septic arthritis by Scedosporium apiospermum after periarticular infiltration]

Antonio Ramos Martínez1, Beatriz Orden Martínez, Jessica Polo Laborda

  • 1Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Majadahonda, Madrid, España. aramos220@gmail.com

Revista Iberoamericana De Micologia
|February 28, 2012
PubMed
Abstract

Insights

Fungal arthritis caused by Scedosporium apiospermum can be challenging to treat. Voriconazole combined with surgical debridement offers an effective solution for this rare infection.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Rheumatology

Background:

  • Fungal arthritis typically arises from bloodstream infections, predominantly affecting immunocompromised individuals or intravenous drug users.
  • In immunocompetent hosts, direct inoculation via invasive devices is the common route for fungal joint infections.
  • Limited data exists on azole antifungal efficacy for fungal arthritis in immunocompetent patients.

Observation:

  • A case of Scedosporium apiospermum-induced arthritis presented with insidious onset.
  • The patient's condition did not improve with posaconazole and caspofungin.
  • Successful treatment was achieved through surgical intervention and voriconazole therapy.

Findings:

  • Scedosporium apiospermum can cause a slowly progressing arthritis.
  • Posaconazole and caspofungin demonstrated limited efficacy against this fungal arthritis.
  • Voriconazole, in conjunction with surgical debridement, led to complete resolution of the infection.

Implications:

  • Surgical debridement is a critical component in managing Scedosporium apiospermum arthritis.
  • Voriconazole represents a viable and effective therapeutic option for this specific fungal joint infection.
  • This case highlights the importance of considering fungal etiologies in refractory arthritis, even in immunocompetent individuals.

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