Native Joint Infections by Aspergillus Species

Area of Science:

• Mycology
• Infectious Diseases
• Rheumatology

Background:

• Septic arthritis due to Aspergillus species is a rare but severe condition.
• Established treatment guidelines are lacking for this fungal infection.
• This study reviews reported cases to clarify epidemiology and management.

Purpose of the Study:

• To review and analyze reported cases of fungal septic arthritis caused by Aspergillus species.
• To clarify the epidemiology, medical, and operative management, and outcomes.
• To inform treatment strategies for Aspergillus-related septic arthritis.

Main Methods:

• A comprehensive literature review of published cases of Aspergillus septic arthritis.
• Data collection on patient demographics, causative Aspergillus species, antifungal treatment (AFT), and surgical interventions.
• Evaluation of treatment efficacy and patient outcomes.

Main Results:

• 30 cases involving 29 hosts were analyzed; the mean age was 45.8 years.
• The knee was the most affected joint (45.7%), with joint pain as the primary symptom (62%).
• Most patients were immunocompromised (72.4%); Aspergillus fumigatus was the most common pathogen (63.3%).
• Amphotericin B (48.3%) and voriconazole (37.9%) were preferred AFTs, with a mean duration of 5.6 months.
• Surgical intervention was common, and treatment was effective in 69% of cases.

Conclusions:

• Aspergillus septic arthritis is a serious clinical challenge.
• Prolonged antifungal therapy combined with surgical intervention is the recommended management approach.
• Accurate identification of the causative Aspergillus species is crucial for effective treatment.