Arthritis without grains caused by Pseudallescheria boydii

• Published in: Mycoses Vol. 38; no. 9‐10; pp. 369 - 371
• Main Authors: Ginter, Gabriele, Hoog, G. S., Pschaid, Andrea, Fellinger, M., Bogiatzis, A., Berghold, C., Reich, E.‐M., Odds, F. C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-09-1995; Blackwell
• Subjects: Adult; Antifungal Agents - therapeutic use; arthritis; Arthritis, Infectious - diagnosis; Arthritis, Infectious - drug therapy; Biological and medical sciences; Diagnosis, Differential; Drug Therapy, Combination; Female; Human mycoses; Humans; Infectious diseases; Itraconazole - therapeutic use; Knee Joint; Medical sciences; Miconazole - therapeutic use; Microscopy, Electron, Scanning; Mitosporic Fungi - ultrastructure; Mycetoma - diagnosis; Mycetoma - drug therapy; Mycoses; Mycoses of the osteoarticular system; Pseudallescheria - isolation & purification; Pseudallescheria - ultrastructure; Pseudallescheria boydii; Scedosporium apiospermum; Scedosporium prolificans; Knee; Human; Opportunistic infection; Mycosis; Diseases of the osteoarticular system; Joint; Differential diagnostic; Fungi; Infection; Case study; Female; Ascomycetes; Thallophyta
• ISSN: 0933-7407; 1439-0507
• DOI: 10.1111/j.1439-0507.1995.tb00066.x

Severe infection of the knee joint by Pseudallescheria boydii in a 23–year‐old female resulted in complete destruction of the cartilaginous surface. The possibility of entry of the fungus through mild abrasions of unperforated skin is discussed. The clinical appearance is compared with that of Scedosporium prolificans. Antimy‐cotic miconazole‐itraconazole treatment, applied during a period of 4 months, was successful; no side‐effects were noted.
Zusammenfassung. Bericht über eine schwere Infektion eines Kniegelenks durch Pseudallescheria boydii bei einer 23–jährigen gesunden Frau. Als Endzustand resultierte eme komplette Zerstörung der knorpeligen Gelenksanteile. Durch eine antimykotische Kombinationsbehandlung mit Miconazol‐Itraconazol über 4 Monate konnte eine Heilung erzielt werden. Signifikante Nebenwir‐kungen wurden nicht beobachtet. Das klinische Erscheinungsbild erinnert an Infektionen durch Scedosporium prolificans. Die Möglichkeit eines Erregereintritts durch ein kutanes Minitrauma muß in Erwägung gezogen werden.