Aspergillus fumigatus joint infection: a review.
OBJECTIVE
To describe a case of joint infection by Aspergillus fumigatus in a unusual site (sacroiliac) and perform a systematic review of such cases described in the literature.


METHODS
We performed a Medline search of the cases of fungal joint of Aspergillus fumigatus in the period ranging from 1970 to 2009.


RESULTS
Following PRISMA Guidelines, 15 cases including ours were reported during this period. Stem cell and solid organ transplantation, hematologic malignancy, and intra-articular steroids injection were the medical conditions found in such patients. The knee followed by the shoulder were the joints more affected. In the cases where synovial fluid analyses were reported, elevated cell count numbers could be found with a predominance of polymorphonuclear neutrophils.


CONCLUSIONS
Fungal joint arthritis is a rare clinical disease most frequently present in immuno-incompetent patients. Rheumatologists should be aware of this condition, where early diagnosis can be associated with good prognosis.
Golmia
Ricardo
R
Rheumatology, Intensive Care and Hematology Section, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Bello
Isabel
I
Marra
Alexandre
A
Hamerschlak
Nelson
N
Osawa
Akemi
A
Scheinberg
Morton
M
D000935:Antifungal Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D001228:Aspergillosis / Q000150:complications / Q000473:pathology* / Q000628:therapy; D001232:Aspergillus fumigatus / Q000302:isolation & purification* / Q000502:physiology; D000077336:Caspofungin; D003131:Combined Modality Therapy; D004322:Drainage; D054714:Echinocandins / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D055666:Lipopeptides; D008875:Middle Aged; D011743:Pyrimidines / Q000627:therapeutic use; D012446:Sacroiliac Joint / Q000382:microbiology / Q000473:pathology*; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D011743:Pyrimidines; D014230:Triazoles; D000077336:Caspofungin; D065819:Voriconazole