Candida Tropicalis Infection of the Knee Joint in an Immunocompromised Pediatric Patient: A Case Report

Abstract

Septic arthritis due to Candida species is a relatively rare infection typically seen in patients with immunocompromising conditions. While C. albicans is the most commonly encountered fungal species affecting humans, C. tropicalis has demonstrated increasing resistance to anti-fungal medications leading to persistent and difficult to control infections [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. C. tropicalis is part of the normal human microbiota and is typically found on the skin and mucosal surfaces of the body. It is the third most common Non-Candida albicans Candida species (NCAC) isolated in clinical practice and primarily found in tropical regions, particularly Asia and South America [1,8]. Few reports of Tropicalis septic arthritis in North America have been published. We present a case report of a confirmed monoarticular C. tropicalis septic arthritis in a pediatric patient with chemotherapy induced granulocytopenia the setting of relapsed acute myeloid leukemia that lead to systemic candidiasis and patient mortality. Case ReportOur patient is a 13-year-old Caucasian female who presented to our institution with relapsed AML following bone marrow transplant with clinical signs and symptoms concerning for graft vs. host disease. She had undergone previous chemotherapy treatment a little over a month prior to her admission and had an indwelling catheter. The patient was scheduled for intrathecal chemotherapy administration and was undergoing preoperative evaluation when it was noticed she had a diffuse rash and endorsing febrile episodes as well as diffuse joint pain. Pre-operative labs showed of white count of 0.1 cells/mm 3 as well as elevated inflammatory markers. She was admitted to our Children's hospital for further work up and evaluation. 2