{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:10:25Z","timestamp":1791835825317,"version":"4.3.4"},"reference-count":112,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2016,11,11]],"date-time":"2016-11-11T00:00:00Z","timestamp":1478822400000},"content-version":"vor","delay-in-days":324,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Scholar of the Save Our Sick Children Foundation"},{"name":"Sharp Family Foundation"},{"name":"Special Account for Research Funds"},{"DOI":"10.13039\/501100005187","name":"National and Kapodistrian University of Athens","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005187","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007313","name":"MD Anderson Cancer Center","doi-asserted-by":"crossref","award":["CA016672"],"award-info":[{"award-number":["CA016672"]}],"id":[{"id":"10.13039\/100007313","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background. \u2003Candida arthritis is a debilitating form of deeply invasive candidiasis. However, its epidemiology, clinical manifestations, management, and outcome are not well understood.<\/jats:p><jats:p>Methods. \u2003Cases of Candida arthritis were reviewed from 1967 through 2014. Variables included Candida spp in joint and\/or adjacent bone, underlying conditions, clinical manifestations, inflammatory biomarkers, diagnostic imaging, management, and outcome.<\/jats:p><jats:p>Results. \u2003Among 112 evaluable cases, 62% were males and 36% were pediatric. Median age was 40 years (range, &amp;lt;1\u201384 years). Most patients (65%) were not pharmacologically immunosuppressed. Polyarticular infection (\u22653 joints) occurred in 31% of cases. Clinical manifestations included pain (82%), edema (71%), limited function (39%), and erythema (22%) with knees (75%) and hips (15%) most commonly infected. Median erythrocyte sedimentation rate was 62 mm\/hr (10\u2013141) and C reactive protein 26 mg\/dL (0.5\u201395). Synovial fluid median white blood cell count was 27 500\/\u00b5L (range, 100\u2013220 000\/\u00b5L) with 90% polymorphonuclear neutrophils (range, 24\u201398). Adjacent osteomyelitis was present in 30% of cases. Candida albicans constituted 63%, Candida tropicalis 14%, and Candida parapsilosis 11%. Most cases (66%) arose de novo, whereas 34% emerged during antifungal therapy. Osteolysis occurred in 42%, joint-effusion in 31%, and soft tissue extension in 21%. Amphotericin and fluconazole were the most commonly used agents. Surgical interventions included debridement in 25%, irrigation 10%, and drainage 12%. Complete or partial response was achieved in 96% and relapse in 16%.<\/jats:p><jats:p>Conclusion. \u2003Candida arthritis mainly emerges as a de novo infection in usually non-immunosuppressed patients with hips and knees being most commonly infected. Localizing symptoms are frequent, and the most common etiologic agents are C albicans, C tropicalis, and C parapsilosis. Management of Candida arthritis remains challenging with a clear risk of relapse, despite antifungal therapy.<\/jats:p>","DOI":"10.1093\/ofid\/ofv207","type":"journal-article","created":{"date-parts":[[2016,1,12]],"date-time":"2016-01-12T01:25:11Z","timestamp":1452561911000},"source":"Crossref","is-referenced-by-count":50,"title":["Candida Arthritis: Analysis of 112 Pediatric and Adult Cases"],"prefix":"10.1093","volume":"3","author":[{"given":"Maria N.","family":"Gamaletsou","sequence":"first","affiliation":[{"name":"Weill Cornell Medicine of Cornell University, Departments of Medicine, Pediatrics, and Microbiology & Immunology, New York, New York"},{"name":"National and Kapodistrian and University of Athens, Greece"},{"name":"Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blandine","family":"Rammaert","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris-Descartes, Sorbonne Paris Cit\u00e9, Assistance Publique H\u00f4pitaux de Paris, Service des Maladies Infectieuses et Tropicales, H\u00f4pital Necker-Enfants Malades, Centre d'Infectiologie Necker-Pasteur, Institut Imagine"},{"name":"Unit\u00e9 de Mycologie Mol\u00e9culaire, Institut Pasteur, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marimelle A.","family":"Bueno","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine of Cornell University, Departments of Medicine, Pediatrics, and Microbiology & Immunology, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos V.","family":"Sipsas","sequence":"additional","affiliation":[{"name":"National and Kapodistrian and University of Athens, Greece"},{"name":"Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Moriyama","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, National Institutes of Health Clinical Center, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios P.","family":"Kontoyiannis","sequence":"additional","affiliation":[{"name":"MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Roilides","sequence":"additional","affiliation":[{"name":"Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, New York"},{"name":"3rd Department of Pediatrics, Aristotle University School of Health Sciences and Hippokration General Hospital, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Zeller","sequence":"additional","affiliation":[{"name":"Osteoarticular Reference Center, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad J.","family":"Taj-Aldeen","sequence":"additional","affiliation":[{"name":"Mycology Laboratory, University of Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy O.","family":"Miller","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine of Cornell University, Departments of Medicine, Pediatrics, and Microbiology & Immunology, New York, New York"},{"name":"Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, New York"},{"name":"Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruta","family":"Petraitiene","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine of Cornell University, Departments of Medicine, Pediatrics, and Microbiology & Immunology, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Lortholary","sequence":"additional","affiliation":[{"name":"Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, New York"},{"name":"Universit\u00e9 Paris-Descartes, Sorbonne Paris Cit\u00e9, Assistance Publique H\u00f4pitaux de Paris, Service des Maladies Infectieuses et Tropicales, H\u00f4pital Necker-Enfants Malades, Centre d'Infectiologie Necker-Pasteur, Institut Imagine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine of Cornell University, Departments of Medicine, Pediatrics, and Microbiology & Immunology, New York, New York"},{"name":"Center for Osteoarticular Mycoses, Hospital for Special Surgery, New York, New York"},{"name":"Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,12,23]]},"reference":[{"key":"2020081005372408100_OFV207C1","doi-asserted-by":"crossref","first-page":"248","DOI":"10.3109\/03009749509100883","article-title":"Fungal arthritis. 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