title: Aspergillus fumigatus joint infection: a review.
abstract: 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.
authors.affiliation: Rheumatology, Intensive Care and Hematology Section, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Golmia
authors.forename: Isabel
authors.initials: I
authors.lastname: Bello
authors.forename: Alexandre
authors.initials: A
authors.lastname: Marra
authors.forename: Nelson
authors.initials: N
authors.lastname: Hamerschlak
authors.forename: Akemi
authors.initials: A
authors.lastname: Osawa
authors.forename: Morton
authors.initials: M
authors.lastname: Scheinberg
mesh_terms: 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
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D011743:Pyrimidines; D014230:Triazoles; D000077336:Caspofungin; D065819:Voriconazole