Fungal arthritis
Mycotic arthritis; Infectious arthritis - fungalFungal 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:
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Blastomycosis
Blastomycosis
Blastomycosis is an infection caused by breathing in the Blastomyces dermatitidis fungus. The fungus is found in decaying wood and soil.
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Candidiasis
Candidiasis
Vaginal yeast infection is an infection of the vagina. It is most commonly due to the fungus Candida albicans.
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Coccidioidomycosis
Coccidioidomycosis
Valley fever is an infection that occurs when the spores of the fungus Coccidioides immitis enter your body through the lungs.
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Cryptococcosis
Cryptococcosis
Cryptococcosis is infection with the fungi Cryptococcus neoformans and Cryptococcus gattii.
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Histoplasmosis
Histoplasmosis
Histoplasmosis is an infection that occurs from breathing in the spores of the fungus Histoplasma capsulatum.
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Sporotrichosis
Sporotrichosis
Sporotrichosis is a long-term (chronic) skin infection that is caused by a fungus called Sporothrix schenckii.
ImageRead Article Now Book Mark Article - 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
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Joint swelling
Joint swelling
Joint swelling is the buildup of fluid in the soft tissue surrounding the joint.
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Swelling of the ankles, feet, and legs
Swelling of the ankles, feet, and legs
Painless swelling of the feet and ankles is a common problem, especially among older people. Abnormal buildup of fluid in the ankles, feet, and legs ...
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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
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Culture of joint fluid to look for fungus
Culture of joint fluid
Joint fluid culture is a laboratory test to detect infection-causing germs in a sample of fluid surrounding a joint.
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Joint x-ray showing joint changes
Joint x-ray
This test is an x-ray of a knee, shoulder, hip, wrist, ankle, or other joint.
Read Article Now Book Mark Article - Positive antibody test (serology) for fungal disease
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Synovial biopsy showing fungus
Synovial biopsy
A synovial biopsy is the removal of a piece of tissue lining a joint for examination. The tissue is called the synovial membrane.
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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 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
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, McInnes IB, O'Dell JR, eds. Kelley and Firestein's Textbook of Rheumatology. 10th ed. Philadelphia, PA: Elsevier; 2017:chap 112.
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The structure of a joint - illustration
Joints, particularly hinge joints like the elbow and the knee, are complex structures made up of bone, muscles, synovium, cartilage, and ligaments that are designed to bear weight and move the body through space. The knee consists of the femur (thigh bone) above, and the tibia (shin bone) and fibula below. The kneecap (patella) glides through a shallow groove on the front part of the lower thigh bone. Ligaments and tendons connect the three bones of the knee, which are contained in the joint capsule (synovium) and are cushioned by cartilage.
The structure of a joint
illustration
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Shoulder joint inflammation - illustration
An inflammation of the shoulder joint can cause pain and restricted joint movement.
Shoulder joint inflammation
illustration
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Fungus - illustration
Fungal infections are caused by microscopic organisms (fungi) that can live on the skin. They can live on the dead tissues of the hair, nails, and outer skin layers.
Fungus
illustration
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The structure of a joint - illustration
Joints, particularly hinge joints like the elbow and the knee, are complex structures made up of bone, muscles, synovium, cartilage, and ligaments that are designed to bear weight and move the body through space. The knee consists of the femur (thigh bone) above, and the tibia (shin bone) and fibula below. The kneecap (patella) glides through a shallow groove on the front part of the lower thigh bone. Ligaments and tendons connect the three bones of the knee, which are contained in the joint capsule (synovium) and are cushioned by cartilage.
The structure of a joint
illustration
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Shoulder joint inflammation - illustration
An inflammation of the shoulder joint can cause pain and restricted joint movement.
Shoulder joint inflammation
illustration
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Fungus - illustration
Fungal infections are caused by microscopic organisms (fungi) that can live on the skin. They can live on the dead tissues of the hair, nails, and outer skin layers.
Fungus
illustration
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Review Date: 11/9/2019
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, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.