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Fungal arthritis

Mycotic arthritis; Infectious arthritis - fungal

 

Fungal arthritis is swelling and irritation (inflammation) of a joint by a fungal infection. It is also called mycotic arthritis.

Causes

 

Fungal arthritis is a rare condition. It can be caused by any of the invasive types of fungi. The infection can result from an infection in another organ, such as the lungs. People with weakened immune systems who travel or live in areas where the fungi are common, are more susceptible to most causes of fungal arthritis.

Conditions that can cause fungal arthritis include:

  • Blastomycosis
  • Candidiasis
  • Coccidioidomycosis
  • Cryptococcosis
  • Histoplasmosis
  • Sporotrichosis
  • Exserohilum rostratum (from injection with contaminated steroid vials)

 

Symptoms

 

The fungus can affect bone or joint tissue. One or more joints can be affected, most often the large, weight-bearing joints, such as the knees.

Symptoms may include any of the following:

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

 

Exams and Tests

 

Your health care provider will examine you.

Tests that may be ordered include:

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

 

Treatment

 

The goal of treatment is to cure the infection using antifungal drugs. Commonly used antifungal drugs are amphotericin B or drugs in the azole family (fluconazole, ketoconazole, or itraconazole).

Chronic or advanced bone or joint infection may require surgery (debridement) to remove the infected tissue.

 

Outlook (Prognosis)

 

How well you do depends on the underlying cause of the infection and the your overall health. A weakened immune system, cancer, and certain medicines can affect the outcome.

 

Possible Complications

 

Joint damage may occur if the infection is not treated right away.

 

When to Contact a Medical Professional

 

Call for an appointment with your provider if you have any symptoms of fungal arthritis.

 

Prevention

 

Thorough treatment of fungal infections elsewhere in the body may help prevent fungal arthritis.

 

 

References

Marquez J, Espinoza LR. Infectious arthritis II: mycobacterial, brucellar, fungal, and parasitic arthritis. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2015:chap 108.

Ohl CA, Forster D. Infectious arthritis of native joints. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 105.

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                Review Date: 12/10/2015

                Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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