What is fungal arthritis?
Fungal arthritis is inflammation of a joint by a fungus microorganism that has invaded the body and is growing in the normally sterile joint. Fungal infection of a joint is a serious condition that can lead to permanent damage to the joint with loss of function.
What causes fungal arthritis?
Fungal arthritis is usually caused by the fungus traveling through the bloodstream to reside in the joint. This manner of infection through the blood is referred to as the hematogenous spread.
Alternatively, if the medication that is contaminated by fungus is directly injected into the joint, fungal arthritis can result. This manner of infection by directly injecting the fungus into the joint is referred to as exogenous inoculation. Rarely, fungal infection can result from a contaminated prosthesis used in joint replacement surgery.
Fungal organisms that can cause fungal arthritis include Candida, Aspergillus, and Exserohilum species.
What are the risk factors for fungal arthritis?
Fungal arthritis in people with normal immune systems is rare. One risk for developing fungal arthritis in such people is the accidental injection of medications that are contaminated with fungus microbes in the vials used. This, in fact, was the situation when contaminated vials of medications produced by a compounding pharmacy (New England Compounding Center) caused a multistate outbreak of rare fungal meningitis and fungal arthritis in September 2012.
People with abnormally suppressed immune systems are at risk for fungal infections, including fungal arthritis. This includes people with severely low white blood counts (neutropenia), HIV infection, injection drug abusers, and those taking chronic cortisone medication.
QUESTION
The term arthritis refers to stiffness in the joints. See AnswerWhat are the symptoms of fungal arthritis?
Symptoms of fungal arthritis include the following:
- Pain
- Heat
- Swelling
- Warmth
- Redness
- Loss of range of motion of the affected joint
The most common joint to develop fungal arthritis is the knee joint. Fever may or may not be present.
Symptoms of fungal arthritis typically become manifest weeks to months after the initial infection of the joint. Ultimately, fungal arthritis can potentially permanently damage the involved joint.
Diagnosis of fungal arthritis
Fungal arthritis is considered when a patient whose immune system is compromised develops inflammation of a joint.
- Blood tests can include testing the blood for the white blood count, inflammation markers (sedimentation rate, or ESR, and C-reactive protein, or CRP), and cultures of the blood.
- Plain X-ray images, CAT scanning, and/or MRI scanning can be used to determine the character and extent of joint damage.
Ultimately, joint fluid is aspirated from the joint with a needle and syringe and this fluid is analyzed in the laboratory to culture the precise fungal organism and establish the diagnosis.
Fungal arthritis is a medical emergency. It is treated by infectious-disease specialists together with orthopedic surgeons.
What is the treatment for fungal arthritis?
Fungal arthritis is treated with antibiotics that are directed against the precise fungal microbe that is causing the joint infection. Examples of antibiotics for fungal arthritis include:
- amphotericin B
- fluconazole (Diflucan)
- caspofungin (Cancidas)
Adequate drainage of the infected joint is an additional essential part of the treatment. This generally requires orthopedic surgical procedures.
There are no home remedies for fungal arthritis.
What is the prognosis for fungal arthritis?
The outlook for fungal arthritis is directly related to how much damage occurs to the cartilage and bone of the joint. Earlier treatment leads to optimal outcomes.
Is it possible to prevent fungal arthritis?
Fungal arthritis can be prevented by minimizing the risks of immune suppression and avoiding intravenous drug abuse. Fungal arthritis can also be prevented by active sterilization measures by companies producing injectable medications.
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Fever
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Arthritis (Joint Inflammation)
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C-Reactive Protein (CRP) Test
C-reactive protein (CRP) is a blood test that doctors can use to detect the risk of heart disease, heart attack, stroke, and peripheral arterial disease. CRP is a highly reactive protein that is found when there is general inflammation within the body.
CT Scan (Computerized Tomography)
A CT scan is an X-ray procedure that combines many X-ray images with the aid of a computer to generate cross-sectional and three-dimensional images of internal organs and structures of the body. A CT scan is a low-risk procedure. Contrast material may be injected into a vein or the spinal fluid to enhance the scan.
Complete Blood Count (CBC)
A complete blood count (CBC) is a calculation of the cellular makeup of blood. A CBC measures the concentration of white blood cells, red blood cells, platelets in the blood, and aids in diagnosing conditions and disease such as malignancy, anemia, or blood clotting problems.
Do Steroids Help With Arthritis?
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Drug Abuse and Addiction
Drug abuse and addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
MRI (Magnetic Resonance Imaging Scan)
MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.
Sedimentation Rate
Sedimentation rate is a common blood test that is used to detect and monitor inflammation in the body. It is performed by measuring the rate at which red blood cells (RBCs) settle in a test tube. The sedimentation rate is simply how far the top of the RBC layer has fallen in one hour, increasing with more inflammation.
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