Infectious Arthritis of Native Joints

A Canker Barking at the Wrong Knee: Thyronectria austroamericana Septic Arthritis

“…The localization of the septic arthritis in this patient’s knee is consistent with the most common joint involved in other cases of mold septic arthritis [ 1 , 4 , 10 ]. Further interview revealed that the patient had a honey locust tree in his backyard, where he often spent time kneeling while cultivating vegetables at his garden.…”

“…Fungal infection is an uncommon cause of chronic septic arthritis but is increasingly seen in immunocompromised or chronically ill patients, although it may sometimes occur in normal hosts [ 1 ]. The most common organisms causing septic fungal arthritis are Candida and Aspergillus species [ 2–4 ].…”

“…Further interview revealed that the patient had a honey locust tree in his backyard, where he often spent time kneeling while cultivating vegetables at his garden. Although the patient was not severely immunosuppressed, he had poorly controlled diabetes and had received an intra-articular steroid injection, which are known predisposing factors for fungal septic arthritis [ 1 , 2 , 11–13 ]. We hypothesize that he acquired the infection through direct inoculation, with an unrecognized minor penetrating injury serving as a portal of entry.…”

“…Treatment of fungal arthritis often requires a combination of surgical debridement and prolonged antifungal therapy [ 1 , 3 , 4 , 10 , 13 ]. Amphotericin B has been the drug of choice of most fungal infections for several decades, but its toxic effects and lack of an equivalent oral form often limit its long-term use [ 3 , 14 ].…”

Disseminated Gonococcal Infection: An Unusual Presentation Resembling a Lupus Flare

“…Most patients with uncomplicated gonorrhea respond well to a 500 mg ceftriaxone intramuscular injection [ 1 ]. However, in 0.5-3.0% of cases, patients will develop disseminated gonococcal infection (DGI) that can progress to septic arthritis in 42%-85% of patients [ 2 , 3 ]. Complement deficiencies and systemic lupus erythematosus (SLE) coincide and are some of the factors known to increase the risk of gonorrhea and DGI [ 3 ].…”