Candida glabrata arthritis: Case report and review of the literature of candida arthritis

We report a case of arthritis due to Candida (Torulopsis) glabrata in two d ifferent joints at different times in the same patient. The first episode o f arthritis was situated in the right ankle and lasted more than 1 year bef ore the patient agreed to the proposed treatment. Therapy with intravenous amphotericin B and oral fluconazole failed. A cure was achieved with weekly intra-articular administration of amphotericin B, which was continued for more than 20 weeks and combined with oral itraconazole. Several weeks later the patient developed Candida glabrata arthritis of the left knee while st ill taking itraconazole. Immediately, intravenous amphotericin B therapy wa s started and was successful. Because there were no previous invasive point manipulations or trauma, the infections were considered to be haematogenou sly disseminated. Chronic corticosteroid and repeated antibiotic therapy fo r infectious exacerbations of chronic obstructive pulmonary disease and alc ohol abuse are the presumed risk factors in this otherwise immunocompetent patient.