Prosthetic Joint Infection Due to<i>Histoplasma capsulatum</i>: Case Report and Review

Vg, Fowler; Fm, Nacinovich; Ja, Alspaugh; Gr, Corey

doi:10.1086/517643

Cited by 41 publications

(20 citation statements)

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“…Septic arthritis caused by H. capsulatum is a rare occurrence, with less 10 cases reported in the literature. The first case of prosthetic joint infection caused by H. capsulatum was reported a few years ago [51]. In this case, the patient presented with sinus tracts in the thigh, overlying a total hip arthroplasty, which had been placed 8 years earlier.…”

Section: Histoplasma Capsulatummentioning

confidence: 95%

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Fungal infections of the bones and joints

Johnson¹,

Perfect

2007

Curr Infect Dis Rep

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Osteoarticular complications may occur with a variety of invasive fungal infections, and seem to be increasing with growing use of prosthetic joints and as the immunosuppressed patient population increases. Epidemiology, pathogenesis, presentation, and management strategies differ somewhat among the different fungal species. This review focuses on recent developments in diagnostic and management approaches for patients with osteoarticular mycoses, and outlines specific treatment strategies for the different species.

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Section: Histoplasma Capsulatummentioning

confidence: 95%

“…Comorbidities precluded removal of the joint, so the patient was managed with oral itraconazole (200 mg daily) as suppressive therapy for life. In four of six other published cases prosthetic joint removal was necessary [51].…”

Section: Histoplasma Capsulatummentioning

confidence: 97%

Fungal infections of the bones and joints

Johnson¹,

Perfect

2007

Curr Infect Dis Rep

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“…Involvement can primarily involve tendons, presenting as carpal tunnel syndrome (121), or be manifest by septic arthritis of either native or prosthetic joints (20,36) and, rarely, osteomyelitis (58). The diagnosis is generally not entertained until culture of surgical material or synovial fluid yields H. capsulatum.…”

Section: Disseminated Histoplasmosismentioning

confidence: 99%

Histoplasmosis: a Clinical and Laboratory Update

2007

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SUMMARY Infection with Histoplasma capsulatum occurs commonly in areas in the Midwestern United States and Central America, but symptomatic disease requiring medical care is manifest in very few patients. The extent of disease depends on the number of conidia inhaled and the function of the host's cellular immune system. Pulmonary infection is the primary manifestation of histoplasmosis, varying from mild pneumonitis to severe acute respiratory distress syndrome. In those with emphysema, a chronic progressive form of histoplasmosis can ensue. Dissemination of H. capsulatum within macrophages is common and becomes symptomatic primarily in patients with defects in cellular immunity. The spectrum of disseminated infection includes acute, severe, life-threatening sepsis and chronic, slowly progressive infection. Diagnostic accuracy has improved greatly with the use of an assay for Histoplasma antigen in the urine; serology remains useful for certain forms of histoplasmosis, and culture is the ultimate confirming diagnostic test. Classically, histoplasmosis has been treated with long courses of amphotericin B. Today, amphotericin B is rarely used except for severe infection and then only for a few weeks, followed by azole therapy. Itraconazole is the azole of choice following initial amphotericin B treatment and for primary treatment of mild to moderate histoplasmosis.

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“…Histoplasmosis is three times more common than tuberculosis as a cause of serious infection in patients receiving TNF‐α blockers 4 . While a sterile immune‐mediated polyarthritis is well recognised to occur in conjunction with symptomatic pulmonary histoplasmosis, 5 localised septic arthritis is exceedingly rare, with only seven case reports in the literature 6 …”

Section: Discussionmentioning

confidence: 99%