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[Fungal osteoarthritis of the knee with joint destruction treated with ketoconazole]
Abstract:
The authors report a case of acute fungal arthritis following traumatic inoculation (bramble prick) in a 9 year-old boy. The implicated fungus was an highly pathogenic atypical strain of Scedosporium (monosporium) apiospermum. Two surgical operations (synovectomy and arthrodesis) and antifungal treatment with ketoconazole led to recovery. The pathogenic role of this fungus and especially the importance of toxic phenomena are discussed. This case is compared with other in the literature. The part of ketoconazole in the recovery of this patient is emphasized.
Insights
A 9-year-old boy recovered from acute fungal arthritis caused by Scedosporium apiospermum after surgery and ketoconazole treatment. This case highlights the fungus
Area of Science:
- Mycology
- Infectious Diseases
- Pediatric Orthopedics
Background:
- Fungal arthritis is a rare but serious infection, often occurring after direct inoculation.
- Scedosporium apiospermum is an emerging fungal pathogen with increasing recognition in human infections.
Observation:
- A 9-year-old boy presented with acute arthritis following a traumatic inoculation from a bramble prick.
- The causative agent was identified as a highly pathogenic atypical strain of Scedosporium (monosporium) apiospermum.
Findings:
- The patient underwent two surgical procedures: synovectomy and arthrodesis.
- Antifungal treatment with ketoconazole was administered.
- Successful recovery was achieved with the combined therapeutic approach.
Implications:
- This case underscores the pathogenic potential of Scedosporium apiospermum, particularly in traumatic inoculation settings.
- The importance of prompt diagnosis and aggressive management, including surgical intervention and appropriate antifungal therapy, is emphasized.
- Ketoconazole demonstrated efficacy in treating this specific fungal arthritis case, warranting further consideration in similar scenarios.