Persistent Candida glabrata infection of the subdeltoid bursa Case report with literature review

This case report describes a case of persistent Candida glabrata (C. glabrata) infection of the subdeltoid bursa and the limitations of arthroscopic treatment. A 41-year-old male patient was referred to this institution with chronic recurrent swelling and restricted movement of the right shoulder. The detection of C. glabrata and isolated subacromial and subdeltoid as well as dorsal subcutaneous fluid collections, were indications for endoscopy of the subdeltoid and subacromial bursa and open surgical debridement of the subcutaneous process. Due to persistent symptoms after several months of resistance-based oral fluconazole and later itraconazole treatment, it was decided to carry out an open surgical intervention. After another 3 months of oral treatment with itraconazole, the infection could finally be eliminated. A C. glabrata bursitis/arthritis is a rare but serious and difficult to treat condition. In addition to early diagnostics, the central pillar of treatment is a thorough surgical debridement and coordinated antimycotic treatment.