A Case of Candida Bursitis Associated with Etanercept Treatment in a Patient with Rheumatoid Arthritis

Kwang Sun Lee; Ha Yeon Lee; Sang-Won Lee; Ho Joong Jung; Jung Soo Song

doi:10.4078/jkra.2008.15.2.175

Journal List > J Korean Rheum Assoc > v.15(2) > 1003621

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Lee, Lee, Lee, Jung, and Song: A Case of Candida Bursitis Associated with Etanercept Treatment in a Patient with Rheumatoid Arthritis

Original Article

J Korean Rheum Assoc 2008;15(2):175-179.

Published online: 20 June 2008

DOI: https://doi.org/10.4078/jkra.2008.15.2.175

A Case of Candida Bursitis Associated with Etanercept Treatment in a Patient with Rheumatoid Arthritis

Kwang Sun Lee, Ha Yeon Lee, Sang-Won Lee, Ho Joong Jung^∗, Jung Soo Song

Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea

^∗Department of Orthopedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea

Received 8 October 2007 Accepted 7 May 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Tumor necrosis factor (TNF)-alpha blockade has been well proved to significantly improve the disease course of rheumatoid arthritis. However, since TNF-alpha plays an important role in the immune system against external infectious organisms, it was reported that TNF-alpha blockade could increase the frequency of serious opportunistic infections such as tuberculosis. Fungal bursitis is a rare infectious disease following sever infections, malignancies and immune deficiencies. Moreover, there was no report on fungal bursitis occurring after administration of TNF-alpha blockade in Korea to date. Recently we experienced a 58-year-od female patient with rheumatoid arthritis who presented soft buttock mass after treatment with etanercept and was finally diagnosed as fungal bursitis by Candida parapsilosis.

Keywords: Etanercept, Candida parapsilosis, Bursitis, Rheumatoid arthritis

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Fig. 1.

non-tender 6×5 cm left buttock soft tissue mass was found.

Fig. 2.

Left ischial bursal mass (arrow) was detected on T2 weighted image of enhanced pelvis MRI (A) and capsular enhancement was showed on T1 weighted image (B).

Fig. 3.

Left ischial bursal biopsy shows degeneration of synovium (A) (H&E, ×100) and chronic inflammation with fibrosis (B) (H&E, ×400).

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