Why This Article Matters

"There is never a lack of research or information available about the pervasiveness of fungal infections in our society today. There is however, a lack of awareness that this is an ongoing problem in society at all ages, as this research article demonstrates. Fungal infections can cause arthritis of any joint in the body. When treated properly, fungal arthritis cases improve and disappear. The use of antibiotics continues to be the primary cause of this problem, followed by, or in conjunction with steroid use. The best approach is to avoid these problems by avoiding use of these medications whenever possible." - Dr. Jeff McCombs, DC


Although healthy subjects may host fungal diseases, various predisposing factors that depress the immune system have been implicated in most patients developing fungal infections or fungal arthritis, or both. Alcoholism, cirrhosis, diabetes, tuberculosis, cancer, prematurity, treatment with corticosteroids, cytotoxic drugs, prolonged use of intravenous antibiotics, intravenous drug abuse, granulocytopenia, and marrow hyperplasia are among the predisposing factors. Neonates are the first group of patients in whom haematogenously originated Candida arthritis can occur. The illness is a hospital acquired disease of sick children with underlying diseases such as the respiratory distress syndrome, and gastrointestinal defects. C albicans, which is responsible for more than 80% of the reported cases, and C tropicalis are the species responsible for this disease. Arthritis is usually present with accompanying metaphysial osteomyelitis. Bone infection might originate from the infected synovium or via the metaphysical vessels. Polyarthritis occurs in most patients and the knee is the joint most often affected. Arthritis originated by haematogenous dissemination beyond the neonatal period is usually a complication of disseminated candidiasis in patients with serious underlying disorders or intravenous drug abusers. C albicans is again the causative organism in about 80% of cases, and C tropicalis is responsible for most of the remaining cases. Two distinct clinical presentations can be observed: (a) acute onset of constitutional and synovial symptoms (about two thirds of patients), with the aetiological diagnosis established within the first week, and (b) indolent presentation, with mild systemic and arthritic symptoms, and delay in the diagnosis for months or years.

Fungal arthritis
Marta L Cuellar, Luis H Silveira, Luis R Espinoza
Annals of the Rheumatic Diseases 1992

Download Full Text PDF:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1005712/pdf/annrheumd00468-0126.pdf


Keywords: fungal arthritis predisposing factors immune system rheumatism knee joints Candida drjefftop