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    Fungal arthritis

    Mycotic arthritis

    Fungal arthritis is infection of a joint by a fungus.

    Causes

    Fungal arthritis, also called mycotic arthritis, is a rare condition. It can be caused by any of the invasive types of fungi. These organisms may affect bone or joint tissue. One or more joints may be affected, most often the large, weight-bearing joints, especially the knees.

    Conditions that can cause fungal arthritis include:

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

    The infection sometimes occurs as a result of an infection in another organ such as the lungs, and tends to get worse very slowly. The large joints are most often affected. People with weakened immune systems who travel or live in endemic areas are more susceptible to most causes of fungal arthritis.

    Symptoms

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

    Exams and Tests

    • 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. The most commonly used antifungal drugs are amphotericin B or medications 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)

    What happens 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.

    Possible Complications

    Joint damage can occur if the infection is not treated promptly.

    When to Contact a Medical Professional

    Call for an appointment with your health care 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

    Espinoza LR. Infections of bursae, joints, and bones. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 293.

    Ohl CA. Infectious arthritis of native joints. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2009: chap 102.

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                  Review Date: 12/6/2011

                  Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; 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. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

                  The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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                  St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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