Fungal arthritis

Alternative names

Mycotic arthritis

Definition

Fungal arthritis is an inflammation of a joint caused by infection by a fungus.

Causes, incidence, and risk factors

Fungal or mycotic arthritis is a very rare condition and may be caused by any of the invasive fungi. These organisms may affect bone or joint tissue. One or more joints may be affected, with the large weight-bearing joints, especially the knee, most commonly affected.

Conditions that may lead to fungal arthritis include the following:

• Coccidioidomycosis
  
• Histoplasmosis
  
• Blastomycosis
  
• Cryptococcosis
  
• Candidiasis
  
• Sporotrichosis
  

The infection usually occurs as a result of an infection in another organ, frequently the lungs, and tends to progress very slowly. Immunocompromised patients are more susceptible to some causes of fungal arthritis.

Symptoms

• Joint swelling
  
• Joint stiffness
  
• Joint pain
  
• Arthritis
  
• Swelling of the ankles, feet, and legs
  

Signs and tests

• Culture of joint fluid that grows fungus
  
• Joint X-ray showing joint changes
  
• Synovial biopsy showing fungus
  
• Positive antibody test (serology) for fungal disease
  
• Skin tests
  

Treatment

The objective of treatment is to cure the infection with antifungal medication. Amphotericin B or medications in the azole family (fluconazole, ketoconazole, or itraconazole) are frequently used antifungal medications.

Chronic or advanced bone or joint infection may require surgical removal (debridement) of infected tissue.

Expectations (prognosis)

The outcome depends in part upon the infecting organism.

Complications

Joint damage can occur if the infection is not treated.

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