title: Histoplasmosis diagnosed after arthroscopy of the knee: case report.
abstract: Fungal arthritis is a rare complication of arthroscopic surgeries, but its possibility should always be considered due its deleterious effects on any joint. Infection caused by the fungus Histoplasma capsulatum is the most common cause of respiratory tract infections by fungi, meanwhile histoplasmosis arthritis is more rare than all other fungal infections. However, their atypical forms of arthritis and the importance of early diagnosis and treatment cannot be over-emphasized. Herein we report a case of knee monoarthritis in an immunocompetent patient with histoplasmosis arthritis following an arthroscopic meniscetomy, diagnosed by synovial biopsy and culture performed during a second arthroscopic procedure. The joint was debrided in this second intervention and the patient received itraconazole initially and fluconazole latter on. The arthritis subsided after 10 months of treatment.
authors.affiliation: Hospital Moinhos de Vento, Porto Alegre, RS, Brazil.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Falster
authors.affiliation: Hospital Moinhos de Vento, Porto Alegre, RS, Brazil.
authors.forename: Maurício B
authors.initials: MB
authors.lastname: Marin
authors.affiliation: Hospital Moinhos de Vento, Porto Alegre, RS, Brazil. Electronic address: joelgo.voy@terra.com.br.
authors.forename: João Luiz Ellera
authors.initials: JL
authors.lastname: Gomes
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D001182:Arthroscopy / Q000009:adverse effects*; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006658:Histoplasma / Q000302:isolation & purification*; D006660:Histoplasmosis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D007719:Knee Joint / Q000382:microbiology*
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D015725:Fluconazole
keywords: Arthritis; Fungal; Histoplasmosis; Knee