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  • Cryptococcus neoformans var. grubii septic arthritis in an immunocompromised patient on haemodialysis with history of splenectomy and sarcoidosis

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Case Reports: Rare disease
Cryptococcus neoformans var. grubii septic arthritis in an immunocompromised patient on haemodialysis with history of splenectomy and sarcoidosis
  1. Demah Alobaidi1,
  2. Abdullahi Elsheikh Mahgoub1,
  3. Ghassan Bachuwa1 and
  4. Danielle Osterholzer2
  1. 1Internal Medicine, Hurley Medical Center / Michigan State University, Flint, Michigan, USA
  2. 2Internal Medicine - Division of Infectious Diseases, Hurley Medical Center / Michigan State University, Flint, Michigan, USA
  1. Correspondence to Dr Ghassan Bachuwa; gbachuw2{at}hurleymc.com

Abstract

A male adult in his mid-40s with end-stage renal disease (ESRD) on haemodialysis, with history of splenectomy and sarcoidosis, developed septic arthritis of the knee. Excision and drainage was performed and empiric antibiotics were initiated. Cultures were initially negative without clinical improvement. Eventually, the aerobic synovial fluid culture grew Cryptococcus neoformans (formerly Cryptococcus neoformans var. grubii). The patient was treated with liposomal amphotericin B and then switched to fluconazole until the infection resolved. This case highlights the less well-recognised association between cryptococcal arthritis and immunodeficiency states like ESRD, splenectomy and sarcoidosis.

  • Cryptococcus
  • Bone and joint infections
  • Dialysis
  • Rheumatology

https://doi.org/10.1136/bcr-2021-248217

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    Footnotes

    • DA and AEM are joint first authors.

    • GB and DO are joint senior authors.

    • GB and DO contributed equally.

    • Contributors DA and AEM designed the study and contributed to the writing, GB and DO contributed to the editing and supervision.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.