Pseudallescheria boydii knee arthritis in a young immunocompetent adult two years after a compound patellar fracture

Joint Bone Spine. 2001 Dec;68(6):517-20. doi: 10.1016/s1297-319x(01)00318-9.


Pseudallescheria boydii arthritis of the knee developed in a 32-year-old immunocompetent man 2 years after a compound patellar fracture contaminated with soil. No other potential portal of entry was identified, suggesting that the fungus remained latent for 2 years. Pseudallescheria arthritis often occurs after a prolonged latency period, causing minimal symptoms that contrast with the frequently severe radiological changes. Although this organism often shows limited sensitivity to most antifungal agents, our patient achieved a full recovery after surgical synovectomy and 6 months of itraconazole therapy (400 mg/ d). This case illustrates the importance of testing for fungi in patients with torpid arthritis, particularly when mild clinical symptoms contrast with severe bone and joint destruction.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Arthritis, Infectious / microbiology*
  • Arthritis, Infectious / pathology
  • Arthritis, Infectious / therapy
  • Fractures, Bone / complications*
  • Fractures, Bone / pathology
  • Humans
  • Itraconazole / therapeutic use
  • Knee Injuries / complications*
  • Knee Injuries / pathology
  • Knee Joint / microbiology*
  • Knee Joint / pathology
  • Magnetic Resonance Imaging
  • Male
  • Mycetoma / complications*
  • Mycetoma / pathology
  • Mycetoma / therapy
  • Patella / injuries
  • Patella / pathology
  • Pseudallescheria / isolation & purification*
  • Synovectomy
  • Treatment Outcome


  • Itraconazole