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Ozone Treatment Unveils the Veil of Candida parapsilosis Infection in the Knee Joint: A Case Report and Literature Review

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Abstract

Candida infection is common, while Candida parapsilosis infection in the knee joint is rare. Local symptoms of Candida infections in the knee are atypical, rarely associated with systemic symptoms, and difficult to distinguish from other types of knee arthritis. We here report a special case of C. parapsilosis infections in the knee joint. A patient had previously undergone knee puncture in a private clinic for the treatment of osteoarthritis and developed a left knee joint infection with C. parapsilosis. However, the patient only showed more severe local knee symptoms, and there was no systemic manifestation associated with any Candida infection. Surprisingly, after receiving ozone lavage, the patient showed symptoms of a systemic infection such as fever and chills. There was no positive finding in the blood cultures. Finally, the synovial fluid cultures showed a C. parapsilosis infections. After antifungal treatment and another knee ozone therapy, the patient did not experience recurrence of the infections. It is suggested that in this special case, the strong sterilization with ozone caused the destruction of C. parapsilosis, leading to a transient systemic toxin reaction. In addition, we reviewed the 17 cases of C. parapsilosis infections that have been reported thus far.

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Acknowledgements

Thanks to the patient we reported for willingness to make his medical records public; in addition, we also thank the Laboratory of Anesthesiology, Affiliated Hospital of Southwest Medical University (Luzhou, China) for providing technical support for our DNA sequencing work; thanks to the Department of Laboratory, Southwest Medical University (Luzhou, China) for completing the Antifungal susceptibility testing.

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This study has not received any funding.

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Author notes

  1. Guo Mu and Hongmei Liu have contributed equally to this work.

Authors and Affiliations

  1. Pain Department, Affiliated Hospital of Southwest Medical University, No. 25 Pacific Street, Luzhou, 646000, China

    Guo Mu, Hongmei Liu, Milian Chen, Xiangbo Liu & Cehua Ou

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  1. Guo Mu
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  2. Hongmei Liu
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  3. Milian Chen
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  4. Xiangbo Liu
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Correspondence to Cehua Ou.

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The authors declare that they have no conflict of interest.

Ethical Approval

This study was proved by the Affiliated Hospital of Southwest Medical University Ethics Committee. This material is original and has not been published in whole or in part elsewhere. All the authors confirm that the checklist for the submission of a case report to Mycopathologia published by Bouchara and Chaturvedi [30] has been completed.

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Mu, G., Liu, H., Chen, M. et al. Ozone Treatment Unveils the Veil of Candida parapsilosis Infection in the Knee Joint: A Case Report and Literature Review. Mycopathologia 185, 545–554 (2020). https://doi.org/10.1007/s11046-020-00447-8

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