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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 and travel to a joint through the bloodstream. A joint can also become infected during a surgery. 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:

  • Removal of joint fluid to look for fungus under a microscope
  • Culture of joint fluid to look for 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 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 for an appointment if you have any symptoms of fungal arthritis.

 

Prevention

 

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

 

 

References

Ohl CA. Infectious arthritis of native joints. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 103.

Ruderman EM, Flaherty JP. Fungal infections of bones and joints. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein and Kelley's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 119.

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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: 11/23/2021

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

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