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Fungal arthritis

Definition

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

Alternative Names

Mycotic arthritis

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 outlook depends on the underlying cause of the infection and the patient's overall health. A weakened immune system, cancer, and certain medications can affect the outcome.

Complications

Joint damage can occur if the infection is not treated.

Calling your health care provider

Call for an appointment with your health care provider if any symptoms of fungal arthritis develop.

Prevention

Thorough treatment of fungal infections elsewhere may help prevent fungal arthritis.

Review Date:11/27/2006
Reviewed By:D. Scott Smith, M.D., MSc, DTM&H, Chief of Infectious Disease & Geographic Medicine, Kaiser Redwood City, CA & Adjunct Assistant Professor, Stanford University. Review provided by VeriMed Healthcare Network.

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