Related Experiment Videos
[Osteoarthritis caused by dematiaceous fungi. Apropos of 3 cases]
Abstract:
Three cases of osteoarthritis due to dematiaceous fungi are reported. The first case, a Drechslera longirostrata spondylitis complicating prosthetic valve fungal endocarditis responded only to the association of Amphotericin B and Ketoconazole. The second patient had chronic osteoarthritis of the knee due to Phialophora parasitica resistant to medical and surgical treatment after renal transplantation. These two cases are the first and the second known reports of clinical infection with these fungi. The third patient had osteoarthritis of the patella complicating a skin infection by a thorn prick. This was cured by surgical excision and 3 months' medical treatment. These cases of infections osteoarthritis of the knee followed subcutaneous abscesses. Deep tissue infections with dematiaceous fungi with osteoarthritic involvement are very rare (6 cases of Drechslera and 8 cases of Phialophora have been reported). These fungi are opportunist saprophytes of plants in subtropical regions. They are characterised on culture by their brown and black pigmentation and microscopy shows septated filaments. Cutaneous effraction is the usual portal of entry in man; patients commonly have depression of their immune systems. Osteoarthritis is generally due to local extension of a subcutaneous abscess. The functional sequellae can be very serious. Treatment comprises surgical excision of the infected tissues with antifungal drugs which may have to be given in association.
Insights
Dematiaceous fungi can cause osteoarthritis, a rare condition. Prompt diagnosis and combined antifungal drug and surgical treatments are crucial for managing these deep tissue infections.
Area of Science:
- Mycology
- Infectious Diseases
- Rheumatology
Background:
- Dematiaceous fungi, plant-associated saprophytes from subtropical regions, rarely cause deep tissue infections.
- These fungi are characterized by brown/black pigmentation and septated hyphae on microscopy.
- Cutaneous inoculation, often from plant matter, is a common entry route, particularly in immunocompromised individuals.
Observation:
- Three cases of osteoarthritis secondary to dematiaceous fungal infections are presented.
- Case 1: Drechslera longirostrata spondylitis following fungal endocarditis, treated with Amphotericin B and Ketoconazole.
- Case 2: Chronic knee osteoarthritis due to Phialophora parasitica in a renal transplant patient, resistant to treatment.
- Case 3: Patellar osteoarthritis from a thorn prick-induced skin infection, resolved with surgery and antifungals.
Findings:
- Deep tissue infections with dematiaceous fungi leading to osteoarthritis are exceptionally rare.
- Osteoarthritis typically arises from the local extension of subcutaneous fungal abscesses.
- Successful treatment often requires a combination of surgical debridement and systemic antifungal therapy.
Implications:
- Highlights the potential for dematiaceous fungi to cause severe joint infections.
- Emphasizes the need for considering fungal etiologies in unexplained osteoarthritis, especially in at-risk populations.
- Underscores the importance of aggressive, combined treatment strategies for favorable outcomes.