First case report of Cryptococcus laurentii knee infection in a previously healthy patient
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CASE REPORT
Open Access
First case report of Cryptococcus laurentii knee infection in a previously healthy patient Hetao Huang1, Jianke Pan2, Weiyi Yang2, Jiongtong Lin1, Yanhong Han1, Kai Lan3, Lingfeng Zeng2,4, Guihong Liang2,4 and Jun Liu2,4*
Abstract Background: The purpose of this case report was to report a case of Cryptococcus laurentii infection in the left knee of a previously healthy 29 year old male patient. Case presentation: After an initial misdiagnosis and 7 months of failed treatment, the patient received nearly a month of treatment with voriconazole (200 mg IV q12 h) and knee irrigation with amphotericin B until the infection was controlled. The treatment continued with fluconazole for nearly 7 months and approximately 5 weeks of antibiotic treatment for a skin bacterial coinfection. In the end, the patient’s symptoms disappeared completely, the left knee recovered well, and there was no recurrence of infection. Conclusion: The key points of successful treatment in this case were the thorough debridement, the adequate course of knee irrigation with antifungal drugs and more than 6 months of oral antifungal drugs that were able to eradicate the infection. Keywords: Fungal infection, Cryptococcus laurentii, Case report
Background Compared with those in high-income countries, musculoskeletal infections including acute osteoarticular infections in children, osteomyelitis, septic arthritis and osteomyelitis with adjacent septic arthritis in developing countries are more common [1]. The Staphylococcus genus remains the most frequent cause of musculoskeletal infections and is responsible for more than 58% of the osteoarticular infections. Coagulase-negative staphylococci were the most frequently isolated bacteria [2]. In recent years, more and more studies have shown that fungal musculoskeletal * Correspondence: [email protected] 2 Department of Sports Medicine, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China 4 Bone and Joint Research Team of Degeneration and Injury, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China Full list of author information is available at the end of the article
infections occur in immunocompromised and previously healthy patients. Fungal bone and joint infection is an uncommon but devastating infection, which requires surgery and long-term antifungal therapy. The mostly commonly reported genera are Candida and Aspergillus, [3] but a wide array of other opportunistic fungi, including Fusarium spp., Scedosporium spp., Mucorales, and dematiaceous molds, have been reported [4]. Among the fungal infections, cryptococcal infection is more serious, which should be paid attention to. There are two main types of cryptococcosis, namely Cryptococcus neoformans and Cryptococcus neoformans. The incidence of infection due to these organisms has increased during the past 40 years, with Cryptococcus laurentii and Cryptococcus albidus being responsible for 80% of all cas
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