Localized tenosynovitis caused by Histoplasma capsulatum: Case report and review of the literature

Tenosynovitis of the Wrist and Thumb and Carpal Tunnel Syndrome Caused by Histoplasma Capsulatum: Case Report and Review of the Literature

“…A literature review of cases of histoplasmosis presenting as tenosynovitis was performed using Pubmed (January 1946 to August 2013) revealing 11 isolated prior cases reported in the literature starting in 1963 [3, 4, 6, 8, 14, 16–19, 21, 25, 26]. Of these 11 cases, only 3 had evidence of disseminated disease [18, 19, 25].…”

“…Sites of involvement reported in the literature most commonly included the flexor tenosynovium at the level of the wrist in 8 cases [3, 6, 14, 16, 17, 19, 25, 26], digital flexor tenosynovitis in 2 cases [4, 18], and the extensor tenosynovium at the level of the wrist in two cases [3, 21]. One case initially involved only the flexor tenosynovium at the level of the carpal tunnel but 1 year later recurred involving the second through fourth extensor tendon compartments [3].…”

“…The most common route of infection is pulmonary via inhalation of aerosolized spores, with lung involvement present in approximately 90 % of cases. Uncommonly other extrapulmonary sites of focal infection have been reported, including musculoskeletal manifestations of oligo- or monoarticular joint [5, 7, 9, 13, 20, 23, 27, 30, 31], bone [1, 10–12, 15, 22, 24], and rarely tenosynovial involvement [3, 4, 6, 8, 14, 16–19, 21, 25, 26]. We report a case of histoplasmosis of the wrist and thumb flexor tendons presenting as an acute carpal tunnel syndrome (CTS) and tenosynovitis.…”

Articular Involvement in Disseminated Histoplasmosis in a Kidney Transplant Patient Taking Azathioprine: Figure 1.

“…Histoplasmosis, caused by H. capsulatum (a dimorphic fungus found in 5 have also been described in disseminated histoplasmosis. Rheumatologic manifestations were noted in 6% (24 of 381) of patients with histoplasmosis during 1 epidemic 6 .…”

A 53-Year-Old Woman With an Unusual Etiology of Joint Pain

“…A recent review of the literature reported 10 cases of tenosynovitis (4/10) and carpal tunnel syndrome (6/10) caused by H. capsulatum (var. capsulatum) [9]. The best response to treatment was achieved with the combination of surgical debridement and antifungal therapy with liposomal amphotericin B.…”