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Histoplasmosis diagnosed after arthroscopy of the knee: case report
Lorenzo Falster1, Maurício B Marin1, João Luiz Ellera Gomes1
1Hospital Moinhos de Vento, Porto Alegre, RS, Brazil.
Abstract:
Fungal arthritis is a rare complication of arthroscopic surgeries, but its possibility should always be considered due its deleterious effects on any joint. Infection caused by the fungus Histoplasma capsulatum is the most common cause of respiratory tract infections by fungi, meanwhile histoplasmosis arthritis is more rare than all other fungal infections. However, their atypical forms of arthritis and the importance of early diagnosis and treatment cannot be over-emphasized. Herein we report a case of knee monoarthritis in an immunocompetent patient with histoplasmosis arthritis following an arthroscopic meniscetomy, diagnosed by synovial biopsy and culture performed during a second arthroscopic procedure. The joint was debrided in this second intervention and the patient received itraconazole initially and fluconazole latter on. The arthritis subsided after 10 months of treatment.
Insights
Fungal arthritis, specifically histoplasmosis arthritis, is a rare complication after arthroscopic knee surgery. Early diagnosis and antifungal treatment are crucial for recovery.
Area of Science:
- Infectious Diseases
- Rheumatology
- Mycology
Background:
- Fungal arthritis is a rare but serious complication following arthroscopic surgery.
- Histoplasmosis arthritis, caused by Histoplasma capsulatum, is less common than other fungal arthropathies.
- Early diagnosis and prompt treatment are essential to prevent joint damage.
Observation:
- A case of knee monoarthritis occurred in an immunocompetent patient post-arthroscopic meniscectomy.
- The patient presented with atypical arthritis symptoms.
- Diagnosis was confirmed via synovial biopsy and culture during a second arthroscopic procedure.
Findings:
- Histoplasmosis arthritis was diagnosed in an immunocompetent patient after knee arthroscopy.
- The affected joint was surgically debrided.
- Antifungal treatment with itraconazole and fluconazole was administered.
Implications:
- This case highlights the importance of considering fungal infections, such as histoplasmosis, in postoperative joint inflammation.
- Prompt diagnosis and appropriate antifungal therapy can lead to successful resolution of fungal arthritis.
- Further research into atypical fungal joint infections post-arthroscopy is warranted.
