Histoplasmosis of the wrist.
We present a case of synovitis of the wrist due to histoplasmosis, diagnosed only after extensive surgery and culturing. Treatment with amphotericin B in combination with radical surgery was effective in curing the disease. This manifestation was probably an exacerbation of a latent chronic infection with Histoplasma capsulatum, although it was unclear why the exacerbation occurred. Synovitis resistant to treatment should be assessed with great care, especially in view of the growing number of immunocompromised patients. Close collaboration between surgeon, rheumatologist, pathologist and microbiologist is paramount in such cases.
Schasfoort
R A
RA
Department of Plastic Surgery and Hand Surgery, Medisch Centrum Leeuwarden, The Netherlands.
Marck
K W
KW
Houtman
P M
PM
D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D002348:Carpal Bones / Q000473:pathology; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006660:Histoplasmosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000209:etiology / Q000473:pathology / Q000628:therapy; D011859:Radiography; D013585:Synovitis / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*
D000935:Antifungal Agents; D000666:Amphotericin B