Wang Jun, Zhang Zhen, Zhang Miao, Yang Bo, Wang Tengyun, Sun Xuedong, Chen Xiuli, Zhang Min Yi, Guo Zhi Yong, Jiang Xin
Department of Joint Surgery, Weifang People's Hospital, Shandong, China.
Medicine (Baltimore). 2019 Feb;98(6):e14327. doi: 10.1097/MD.0000000000014327.
Knee joint infection caused by isolated primary Candida is extremely rare, with only a few cases reported. It occurs most often in patients with predisposing factors (e.g., immunosuppression, malignancy, drug abuse) or fungal invasion during traumatic procedures, including surgery. We report an unusual case of Candida parapsilosis infection in the knee joint with no predisposing factors.
A 65-year-old man entered our hospital complaining of persistent pain and mild swelling of the right knee that seriously affected normal walking. There was no obvious cause for his distress.
The case was eventually diagnosed as a primary Candida parapsilosis infection which had many diagnostic particularities and difficulties.
Total knee arthroplasty (TKA) was ultimately performed followed by fluconazole coverage.
The patient showed good clinical performance at the 3- and 6-month follow-up visits and was very satisfied with the therapeutic effect.
If there were suspected symptoms of primary Candida infection cases, imaging and microscopic examinations, tissue cultures, and pathological examination of the puncture knee joint fluid were required.
由孤立的原发性念珠菌引起的膝关节感染极为罕见，仅有少数病例报道。它最常发生于有易感因素（如免疫抑制、恶性肿瘤、药物滥用）的患者或在包括手术在内的创伤性操作过程中发生真菌入侵的患者。我们报告一例无易感因素的膝关节近平滑念珠菌感染的罕见病例。
一名65岁男性因右膝持续疼痛和轻度肿胀入院，严重影响正常行走。其疼痛无明显病因。
该病例最终被诊断为原发性近平滑念珠菌感染，有许多诊断特殊性和困难。
最终进行了全膝关节置换术（TKA），随后给予氟康唑治疗。
患者在3个月和6个月的随访中临床症状改善良好，对治疗效果非常满意。
如果存在原发性念珠菌感染病例的疑似症状，需要对膝关节穿刺液进行影像学和显微镜检查、组织培养及病理检查。
