First case report of Cryptococcus laurentii knee infection in a previously healthy patient

BMC Infect Dis. 2020 Sep 17;20(1):681. doi: 10.1186/s12879-020-05401-z.

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: Case report; Cryptococcus laurentii; Fungal infection.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Adult
  • Amphotericin B / therapeutic use
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use*
  • Arthritis, Infectious / microbiology
  • Cryptococcosis / drug therapy*
  • Cryptococcosis / microbiology*
  • Cryptococcosis / surgery
  • Cryptococcus / isolation & purification
  • Debridement
  • Diagnostic Errors
  • Fluconazole / therapeutic use
  • Focal Infection / drug therapy
  • Focal Infection / microbiology
  • Focal Infection / surgery
  • Humans
  • Knee / diagnostic imaging
  • Knee / microbiology*
  • Knee / surgery
  • Male
  • Skin Diseases, Bacterial / drug therapy
  • Voriconazole / therapeutic use

Substances

  • Antifungal Agents
  • Amphotericin B
  • Fluconazole
  • Voriconazole