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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 which travels to a joint through the bloodstream. A joint can also become infected during a surgery or injury. People with weakened immune systems who travel or live in areas where specific 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

 

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:

  • Removal of joint fluid to look for fungus under a microscope
  • Culture of joint fluid to look for fungus
  • Joint x-ray that may show 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 medicines. Commonly used antifungal medicines are amphotericin B or medicines 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 your overall health. A weakened immune system, cancer, and certain medicines can affect the outcome.

 

Possible Complications

 

Joint damage may occur and the risk of damage is higher if the infection is not treated right away.

 

When to Contact a Medical Professional

 

Contact 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.

 

 

Open References

References

Denmeade TA, Ohl CA. Infectious arthritis of native joints. In: Blaser MJ, Cohen JI, Holland SM, et al, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 10th ed. Philadelphia, PA: Elsevier; 2026:chap 105.

Ruderman EM, Flaherty JP. Fungal infections of bones and joints. In: Firestein GS, McInnes IB, Koretzky GA, Mikuls TR, Neogi T, O'Dell JR, eds. Firestein and Kelley's Textbook of Rheumatology. 12th ed. Philadelphia, PA: Elsevier; 2025:chap 115.

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  • The structure of a joint

    The structure of a joint

    illustration

  • Shoulder joint inflammation

    Shoulder joint inflammation

    illustration

  • Fungus

    Fungus

    illustration

    • The structure of a joint

      The structure of a joint

      illustration

    • Shoulder joint inflammation

      Shoulder joint inflammation

      illustration

    • Fungus

      Fungus

      illustration

    A Closer Look

     

    Talking to your MD

     

      Self Care

       

        Tests for Fungal arthritis

         
         

        Review Date: 12/13/2025

        Reviewed By: Jatin M. Vyas, MD, PhD, Roy and Diana Vagelos Professor in Medicine, Columbia University Vagelos College of Physicians and Surgeons, Division of Infectious Diseases, Department of Medicine, New York, NY. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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