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  • Title: Pseudallescheria boydii knee arthritis in a young immunocompetent adult two years after a compound patellar fracture.
    Author: Lavy D, Morin O, Venet G, Maugars Y, Prost A, Berthelot JM.
    Journal: Joint Bone Spine; 2001 Dec; 68(6):517-20. PubMed ID: 11808991.
    Abstract:
    Pseudallescheria boydii arthritis of the knee developed in a 32-year-old immunocompetent man 2 years after a compound patellar fracture contaminated with soil. No other potential portal of entry was identified, suggesting that the fungus remained latent for 2 years. Pseudallescheria arthritis often occurs after a prolonged latency period, causing minimal symptoms that contrast with the frequently severe radiological changes. Although this organism often shows limited sensitivity to most antifungal agents, our patient achieved a full recovery after surgical synovectomy and 6 months of itraconazole therapy (400 mg/ d). This case illustrates the importance of testing for fungi in patients with torpid arthritis, particularly when mild clinical symptoms contrast with severe bone and joint destruction.
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