Native Joint Infections by Species.

BACKGROUND

Septic arthritis due to spp. represents a rare, but severe disease. Nevertheless, clear guidelines regarding most effective medical treatment have not yet been established. The present study is a literature review of all reported cases of fungal septic arthritis due to spp, in order to clarify epidemiology, as well as the medical and operative management and their outcome.

METHODS

A meticulous review of all published septic arthritis infections due to has been conducted. Information regarding demographics, causative fungus, antifungal treatment (AFT), surgical intervention, as well as the infection's outcome were recorded and evaluated.

RESULTS

A total of 30 spp. strains from 29 hosts have been studied. The patients' mean age was 45.8 years. The most commonly affected joint was the knee (45.7%), while the predominant symptom was joint pain (62%). Most patients were immunocompromised (72.4%). Diagnosis was established through cultures and/or histopathology. was the most common responsible fungi (63.3%), followed by (16.6%) and (10%). Regarding AFT, the preferred agent proved to be Amphotericin B (14 cases; 48.3%), followed by voriconazole (11; 37.9%), while the mean AFT duration was 5.6 months. In most cases surgical treatment was also performed (in 4 cases no surgery was reported). Treatment was effective in 20 cases (69%).

CONCLUSIONS

Septic arthritis caused by spp. represents a severe clinical entity. It seems that, with the available data, prolonged AFT along with surgical intervention is the preferred management of this infection, while identification of the responsible fungus is of utmost importance.