Candida albicans tenosynovitis of the hand

An immunosuppressed 72 year-old woman presented with bilateral hand-fingers tenderness and increased circumference. Serum leukocyte and neutrophil counts were slightly raised and C-reactive protein moderately increased. On ultrasound there was flexor tenosynovitis of the 3rd right and 1st to 4th left hand-fingers and left common flexor tendon sheet. Candida albicans was isolated in synovial fluid cultures and the symptoms resolved with fluconazole. This is the first case reporting bilateral Candida tenosynovitis of the hand, highlighting the possible role of concealed hematogenous spread of opportunistic microorganisms in atypical clinical manifestations in immunocompromised patients.