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Case Reports in Rheumatology
Volume 2016 (2016), Article ID 2019250, 5 pages
http://dx.doi.org/10.1155/2016/2019250
Case Report

Olecranon Bursitis Caused by Candida parapsilosis in a Patient with Rheumatoid Arthritis

Division of Rheumatology, Department of Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936-5067, USA

Received 9 May 2016; Revised 14 July 2016; Accepted 17 July 2016

Academic Editor: George S. Habib

Copyright © 2016 Carla F. Gamarra-Hilburn et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Septic bursitis is usually caused by bacterial organisms. However, infectious bursitis caused by fungi is very rare. Herein, we present a 68-year-old woman with long-standing rheumatoid arthritis who developed pain, erythema, and swelling of the right olecranon bursa. Aspiration of the olecranon bursa showed a white blood cell count of (41% neutrophils, 30% lymphocytes, and 29% monocytes). Fluid culture was positive for Candida parapsilosis. She was treated with caspofungin 50 mg intravenously daily for 13 days followed by fluconazole 200 mg orally daily for one week. She responded well to this treatment but had recurrent swelling of the bursa. Bursectomy was recommended but she declined this option. This case, together with other reports, suggests that the awareness of uncommon pathogens, their presentation, and predisposing risk factors are important to establish an early diagnosis and prevent long-term complications.