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[Fungal osteoarthritis]
Revue Du Rhumatisme Et Des Maladies Osteo-Articulaires
|February 1, 1981
Summary
Bone and joint fungal infections (mycoses) are categorized into those from blood spread and traumatic inoculation. Opportunistic fungi like Candida and Cryptococcus, and exotic fungi such as Histoplasma, cause these infections, requiring targeted antifungal treatments.
Area of Science:
- Mycology
- Infectious Diseases
- Rheumatology
Context:
- Bone and joint mycoses present diagnostic and therapeutic challenges.
- Understanding the routes of fungal infection is crucial for effective management.
- The Pasteur Institute's Mycology unit contributes significant clinical experience.
Purpose:
- To classify bone and joint mycoses into two main groups: hematogenous spread and traumatic inoculation.
- To review the literature and present clinical experience with various fungal pathogens affecting bones and joints.
- To highlight the role of immunological reactions and current antifungal therapies.
Summary:
- Fungal osteoarthritis can arise from bloodstream infections (e.g., Candida, Cryptococcus) or direct inoculation (e.g., mycetomas, actinomycoses).
- Specific examples include Candida albicans arthritis in newborns, cryptococcosis with bone involvement, and African histoplasmosis.
- Traumatic inoculation can lead to fungal mycetomas, actinomycoses, sporotrichosis, and rare cases like Beauveria sp. arthritis.
- Immunoelectrophoresis aids diagnosis and treatment monitoring.
- Antifungal agents such as amphotericin B, 5-fluorocytosine, and ketoconazole are standard treatments.
Impact:
- Provides a framework for understanding and diagnosing diverse fungal bone and joint infections.
- Emphasizes the importance of considering fungal etiologies in bone and joint pathology.
- Informs clinical practice regarding diagnostic tools and therapeutic strategies for mycoses affecting the musculoskeletal system.