Fungal arthritis of the wrist caused by Candida parapsilosis during infliximab therapy for rheumatoid arthritis

Abstract

A 60-year-old woman with rheumatoid arthritis, who had been treated with infliximab, presented with uncontrollable wrist arthritis. Fungal arthritis caused by Candida parapsilosis was confirmed by examining her aspirated joint fluid. Her infliximab therapy was interrupted, and antifungal therapy with fluconazole was started. After the fungal infection had been ameliorated, surgical debridement and arthrodesis of the wrist joint were conducted, and her symptoms completely resolved. Although fungal arthritis is rare, it should be considered as a differential diagnosis of exacerbated monoarthritis in patients treated with biological agents.

Keywords::

• Candida parapsilosis
• Infection
• Infliximab
• Fungal arthritis
• Rheumatoid arthritis