Elbow osteomyelitis by Candida tropicalis in acute lymphoblastic leukemia. A case report.

Abstract

Introduction: musculoskeletal involvement of the extremities is common in pediatric patients with acute lymphoblastic leukemia. The insidious and oligosymptomatic presentation of several musculoskeletal conditions in these patients often leads to different diagnostic suspicions, which may delay appropriate management of the pathology. Non-albicans Candida osteoarticular infections are a rare entity that may affect immunodeficient patients. We describe a case of osteoarticular infection caused by an opportunistic fungus in a pediatric patient with acute lymphoblastic leukemia during the second week of rest post-consolidation block.

Case presentation: we present a case of a 4-year-old girl diagnosed with B-cell acute lymphoblastic leukemia that developed an elbow infection by Candida tropicalis. Two surgical debridements of the elbow, combined with the administration of antifungals, were required to control the infection. She fully recovered at six months postoperatively and remains without osteoarticular sequelae at three years of follow up.

Conclusion: C. tropicalis infection should be included in the differential diagnosis of osteoarticular complications in immunocompromised patients with acute lymphoblastic leukemia (ALL). Prompt diagnosis and treatment are essential to avoid osteoarticular sequelae.