Fungal arthritis simulating juvenile rheumatoid arthritis

Petriellidium boydii is often isolated from maduromycosis but has recently been associated with arthritis. A previously healthy 6-year-old boy developed chronic purulent arthritis of the knee after a bicycle accident. Culture of aspirate grew no pathogens and antibiotic treatment had no effect. Cult...

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Bibliographic Details
Published in:BMJ 1982-10, Vol.285 (6346), p.923-924
Main Authors: Haapasaari, J, Essen, R V, Kahanpää, A, Kostiala, A A, Holmberg, K, Ahlqvist, J
Format: Article
Language:English
Subjects:
Antifungal Agents - therapeutic use
Arthritis
Arthritis, Infectious - diagnosis
Arthritis, Infectious - drug therapy
Arthritis, Infectious - etiology
Arthritis, Juvenile - diagnosis
Ascomycota
Child
Clinical Research
Diagnosis, Differential
Erythrocyte sedimentation rate
Fungal infections
Fungi
Hospital admissions
Humans
Imidazoles - therapeutic use
Infections
Ketoconazole
Knee Injuries - complications
Male
Mycoses - diagnosis
Mycoses - etiology
Piperazines - therapeutic use
Pseudallescheria
Synovial fluid
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Summary:Petriellidium boydii is often isolated from maduromycosis but has recently been associated with arthritis. A previously healthy 6-year-old boy developed chronic purulent arthritis of the knee after a bicycle accident. Culture of aspirate grew no pathogens and antibiotic treatment had no effect. Culture of synovial fluid grew P boydii, which responded initially to amphotericin but reappeared after six months. Subsequent treatment with miconazole was stopped after development of haematuria. The fungus was sensitive to ketoconazole, and treatment with this drug cured the infection. With the introduction of ketoconazole it is of practical importance to recognise fungal infections.
ISSN:0007-1447
0267-0623
0959-8138
1468-5833
DOI:10.1136/bmj.285.6346.923