Primary Cryptococcal Tenosynovitis in a Patient with Rheumatoid Arthritis
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Here, we report a case of primary cryptococcal tenosynovitis and arthritis caused by worsened cellulitis in a patient with rheumatoid arthritis (RA) who had been taking methotrexate and leflunomide. The patient, injured during the soybean harvest, failed to respond to empirical antibiotic therapy for presumed bacterial cellulitis on the dorsum of the right hand. An operative procedure was performed. Cryptococcocal tenosynovitis was diagnosed upon histopathological examination of the lesion. Treatment with 400 mg of fluconazole daily for 3 months led to the complete disappearance of skin lesions, with slight limitation of finger extension. The patient was examined continuously for 2 years, and there was no evidence of relapse or dissemination to other organs. This case indicates that primary cryptococcal skin and soft tissue infections must be included in the differential diagnoses of antibioticsrefractory soft tissue infections, especially in immunocompromised patients.
Abstract
Here, we report a case of primary cryptococcal tenosynovitis and arthritis caused by worsened cellulitis in a patient with rheumatoid arthritis (RA) who had been taking methotrexate and leflunomide. The patient, injured during the soybean harvest, failed to respond to empirical antibiotic therapy for presumed bacterial cellulitis on the dorsum of the right hand. An operative procedure was performed. Cryptococcocal tenosynovitis was diagnosed upon histopathological examination of the lesion. Treatment with 400 mg of fluconazole daily for 3 months led to the complete disappearance of skin lesions, with slight limitation of finger extension. The patient was examined continuously for 2 years, and there was no evidence of relapse or dissemination to other organs. This case indicates that primary cryptococcal skin and soft tissue infections must be included in the differential diagnoses of antibioticsrefractory soft tissue infections, especially in immunocompromised patients.
참고문헌 (20)
- Chayakulkeeree M., "Cryptococcosis", Infect Dis Clin North Am, 2, pp.507~544 (2006)
- Lin X., "The biology of the Cryptococcus neoformans species complex", Annu Rev Microbiol, 60, pp.69~105 (2006)
- Christianson JC., "Primary cutaneous cryptococcosis in immunocompetent and immunocompromised hosts", Med Mycol, 41, pp.177~188 (2003)
- Neuville S., "Primary cutaneous cryptococcosis : a distinct clinical entity", Clin Infect Dis, 36, pp.337~347 (2003)
- Hafner C., "Primary cutaneous cryptococcosis and secondary antigenemia in a patient with long-term corticosteroid therapy", Infection, 33, pp.86~89 (2005)
- Zorman JV., "Primary cutaneous cryptococcosis in a renal transplant recipient : case report", Mycoses, 53, pp.535~537 (2010)
- Bruno KM., "Cryptococcal arthritis, tendinitis, tenosynovitis, and carpal tunnel syndrome : report of a case and review of the literature", Arthritis Rheum, 47, pp.104~108 (2002)
- Horcajada JP., "Invasive Cryptococcosis and adalimumab treatment", Emerg Infect Dis, 13, pp.953~955 (2007)
- 정선미, "베게너육아종증 환자에서 발병된 크립토코쿠스 건초염 1예", 대한류마티스학회지, 11(1), pp.67~71 (2004), 대한류마티스학회
- Park J., "Cryptococcal tenosynovitis in the setting of disseminated cryptococcosis", J Rheumatol, 27, pp.282~283 (2000)
- Kang HY., "Primary cutaneous cryptococcosis treated with fluconazole", Korean J Dermatol, 38, pp.838~840 (2000)
- Kim DH., "A case of primary cutaneous cryptococcosis in a patient with iatrogenic Cushing's syndrome", Korean J Med Mycol, 3, pp.195~199 (1998)
- Kim HJ., "Two cases of cutaneous cryptococcosis mimicking cellulitis", Korean J Med Mycol, 3, pp.190~194 (1998)
- Kim YJ., "A case of primary cutaneous cryptococcosis misdiagnosel as skin tuberculosis", Korean J Med Mycol, 8, pp.16~20 (2003)
- Probst C., "Cryptococcosis mimicking cutaneous cellulitis in a patient suffering from rheumatoid arthritis : a case report", BMC Infect Dis, 10, pp.239~ (2010)
- Leão CA., "Primary cutaneous cryptococcosis caused by Cryptococcus gattii in an immunocompetent host", Med Mycol, 49, pp.352~355 (2011)
- Pau M., "Primary cutaneous cryptococcosis in an immunocompetent host", Mycoses, 53, pp.256~258 (2010)
- Saag MS., "Practice guidelines for the management of cryptococcal disease. Infectious Diseases Society of America", Clin Infect Dis, 30, pp.710~718 (2000)
- Perfect JR., "Clinical practice guidelines for the management of cryptococcal disease : 2010 update by the infectious diseases society of america", Clin Infect Dis, 50, pp.291~322 (2010)
- Baumgarten KL., "Primary cutaneous cryptococcosis in a lung transplant recipient", South Med J, 97, pp.692~695 (2004)