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The involvement of osseous and articular system in cryptococcosis occurs particularly in the disseminated forms of the infection, affecting mostly immunossupressed hosts. The bone system is compromised in 5 to 10% of the cases, and the articular system is rarely implicated. Until now, there are 31 related cases of cryptococcal arthritis in the medi...
Citations
... Their synovial fluid is cloudy and viscous due to the presence of pus. 5,8 The most common management reported in the literature is to collect specimens for culture, request a microbiological analysis, drain the abscess, and debride the infected tissue. Therapy usually consists of amphotericin B administration for a short time, followed by an azole compound, such as fluconazole, for longer periods. ...
... Therapy usually consists of amphotericin B administration for a short time, followed by an azole compound, such as fluconazole, for longer periods. 5,7 Although some authors perform treatment with antifungal agents alone and others do only arthrodesis, evidence suggests that clinical and surgical management promote better outcomes. 8 ...
Resumo
Osteomielites fúngicas, principalmente associadas à artrite séptica, são incomuns no Brasil, e por isso às vezes de difícil diagnóstico e tratamento. Relatamos um caso de uma paciente jovem, sem fator de risco imunossupressor, com o desenvolvimento de uma osteomielite e evolução para artrite séptica do quadril. O diagnóstico foi realizado após a sua drenagem cirúrgica e visualização do Cryptococcus Neoformans à anatomia patológica. Foi instaurado o tratamento antifúngico, com remissão total dos sintomas. Como não há consenso em relação ao tratamento de osteomielites fúngicas, descrevemos este relato de caso para atentar ortopedistas sobre a importância do diagnóstico diferencial nas artrites de quadril e a boa evolução do tratamento clínico após a drenagem e isolamento do patógeno.
Almost 200 species fungus are associated with human infections have been described. The musculoskeletal involvement can develop by direct extension of a lesion or by inoculation and hematogenous spread. The joint infection has an indolent course and diagnosis tends to be delayed because of the paucity of clinical signs and the rarity of the pathology. Despite the small number of fungal species involved, the incidence of diseases they can provoke has increased over the last 40 years particularly in hospital environments which has resulted in individuals having their immunologic system compromised. There is no special prevalence for gender or age. A review of the joint involvement in such conditions is described on this chapter.
