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Intra-articular amphotericin B treatment of Sporothrix schenckii arthritis
N J Downs1, D R Hinthorn, V R Mhatre
1Department of Medicine, University of Kansas College of Health Sciences, Kansas 66103.
Abstract:
Arthritis caused by Sporothrix schenckii may not respond satisfactorily to a full course of intravenous amphotericin B therapy. Left untreated, the fungus continues to be recovered from cultures of joint fluid, and the patient typically has serious joint disability. We have shown in one patient with sporotrichosis of the knee that direct low-dose injections of amphotericin B can be performed safely, resulting in eradication of the fungus. The patient has had continued useful range of motion and weight bearing on the involved knee.
Insights
Sporothrix schenckii fungal arthritis often resists standard treatment. Direct, low-dose amphotericin B injections into the knee joint successfully eradicated the fungus in one patient, preserving joint function.
Area of Science:
- Mycology
- Rheumatology
- Infectious Diseases
Background:
- Arthritis caused by Sporothrix schenckii (sporotrichosis) can be challenging to treat.
- Intravenous amphotericin B is a standard therapy but may not always be effective for joint infections.
Observation:
- The fungus persisted in joint fluid cultures despite standard treatment.
- Patients with untreated fungal arthritis often experience severe joint disability.
Findings:
- Direct, low-dose intra-articular injections of amphotericin B were safely administered to a patient with knee sporotrichosis.
- Fungal eradication was achieved following the direct injection therapy.
Implications:
- Intra-articular amphotericin B may be a viable, localized treatment option for recalcitrant fungal arthritis.
- This approach can potentially prevent joint destruction and preserve function in patients with fungal joint infections.