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

Table 1

Demographic features, clinical manifestations, treatment, and outcome of septic bursitis caused by Candida species.

Case number	Candida strain/culture site	Author/year of publication	Age/sex	Infected bursa	Clinical presentation of bursitis	Comorbidities	Other risk factors	Probable source of infection	Treatment	Outcome
1	C. albicans; Bursal fluid	Rosochmann and Bell/1987; [1]	73/M	Subacromial	Acute, 5 days	SLE	Corticosteroids	Fungemia	Amphotericin B	Complete resolution
2	C. glabrata; Phlegmon-like material form olecranon bursae	Skedros et al./2013; [12]	63/F	Olecranon	Acute, 2 weeks after corticosteroid injection	COPD; Arterial hypertension; Hypothyroidism; Recurrent oropharyngeal candidiasis	Prednisone 10 mg daily	Corticosteroid injection	Caspofungin; Debridement, irrigation, and bursectomy	Complete resolution
3	C. lusitaniae; Bursal fluid	Behar and Chertow/1998; [13]	59/F	Olecranon	Chronic, 6 months	SLE; Diabetes; Asthma	Methotrexate 15 mg weekly; Prednisone 30 mg daily	Superficial trauma	Fluconazole 100 mg a day; 5-fluorocytosine	Recurrence after several months
4	C. parapsilosis; Bursal fluid	Schlesinger and Hoffman/1995; [7]	62/F	Olecranon	Acute	Breast cancer; COPD	Prednisone 40 mg daily	Undetermined	Amphotericin B IV over 9 days; Ketoconazole (400 mg/d for 2 months)	Complete resolution
5	C. parapsilosis; Bursal fluid	Jiménez-Palop et al./2002; [3]	32/M	Olecranon	Chronic, around 3 months	None	None	Corticosteroid injection	Fluconazole 400 mg for 7 days, followed by 200 mg a day; Bursectomy	Complete resolution
6	C. parapsilosis; Bursa tissue culture	Miyamoto et al./2012; [11]	60/F	Olecranon	Duration of the disease not mentioned. It presented 7 months after infliximab therapy was started	RA	Infliximab; Methotrexate Prednisolone	Undetermined	Bursectomy	Complete resolution of bursitis. Later developed wrist arthritis
7	C. parapsilosis; Shoulder synovial fluid; Tissue culture	Jeong et al./2013; [10]	74/M	Subacromial, subdeltoid, and subcoracoid	Chronic, >18 months	None	None	Undetermined	Fluconazole (neither dose nor length of therapy specified); Surgical exploration with drainage, debridement, and bursectomy	Complete resolution
8	C. parapsilosis; Bursal fluid	Current case	68/F	Olecranon	Acute, 1-2 weeks after bursa aspiration and corticosteroid injection	RA; Infected ulcer	None	Corticosteroid injection	Caspofungin 50 mg IV daily for 2 weeks, followed by fluconazole 200 mg a day for 1 week	Persistence
9	C. tropicalis; Bursal fluid; Urine; Blood	Murray et al./1976; [8]	77/M	Olecranon	Chronic	Bladder cancer; Syphilis; Sepsis	Neutropenia; Urethral and venous catheters	Fungemia	Amphotericin B IV for 9 weeks; Bursectomy	Complete resolution
10	C. tropicalis; Blood; Fluid from ruptured bursae	Wall et al./1982; [9]	48/M	First, knee septic arthritis; later, popliteal bursitis	Acute, 2 weeks after chemotherapy	Lymphocytic lymphoma	Chemotherapy; Methotrexate; Corticosteroids; Neutropenia	Fungemia	Amphotericin B IV for 5 months; Bursectomy and calf dissection	Complete resolution
11	Candida species; No cultures, diagnosis done by histopathology	Khazzam et al./2005; [4]	65/M	Subacromial	Chronic, >4 months	Myocardial infarction	None	Corticosteroid injection	Voriconazole 200 mg twice daily for 6 weeks; Bursectomy	Complete resolution

C: Candida; M: male; F: female; SLE: systemic lupus erythematosus; COPD: chronic obstructive pulmonary disease; IV: intravenous; RA: rheumatoid arthritis.