Candida albicans tenosynovitis of the hand

Area of Science:

• Infectious Diseases
• Rheumatology
• Immunology

Background:

• Immunocompromised patients are susceptible to opportunistic infections.
• Fungal infections, such as Candida albicans, can present with atypical manifestations.
• Tenosynovitis is inflammation of the tendon sheath, often presenting with pain and swelling.

Observation:

• A 72-year-old immunocompromised woman presented with bilateral hand and finger tenderness and swelling.
• Elevated white blood cell and neutrophil counts, along with moderately increased C-reactive protein, were noted.
• Ultrasound revealed flexor tenosynovitis in multiple fingers of both hands.

Findings:

• Synovial fluid cultures confirmed Candida albicans infection.
• The patient's symptoms resolved completely after treatment with fluconazole.
• This represents the first reported case of bilateral Candida tenosynovitis of the hand.

Implications:

• This case underscores the importance of considering opportunistic fungal infections in immunocompromised individuals with unusual presentations.
• Hematogenous spread of Candida albicans can lead to tenosynovitis, even in the hands.
• Early recognition and appropriate antifungal therapy are crucial for favorable outcomes in such cases.