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Arthritis, Infectious, Granulomatous

Jacqueline L. Yurgil, DO Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Invasion of joints by microorganisms; often as part of a systemic infection/disease

  • System(s) affected: musculoskeletal

  • Synonym(s): fungal arthritis; mycobacterial arthritis; subacute ...

DIAGNOSIS

HISTORY

  • Predominantly monoarticular (90%)

  • Fungal arthritis may present as a migratory polyarthritis, particularly with Coccidioides immitis and Histoplasma capsulatum

  • Oligoarticular reactive ar...

TREATMENT

GENERAL MEASURES

  • Fungal: Hospitalize for parenteral therapy

  • Mycobacterial: outpatient

  • Brucella: outpatient

  • A bedside arthrocentesis (minimally invasive) or arthroscopic drainage (benefit of debr...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Treatment of mycobacterial arthritis requires monthly CBC. Assess liver and kidney toxicity, and urinalysis

  • Verify normalization of inflammatory ...

REFERENCES

1
Magnussen  A, Dinneen  A, Ramesh  P. Osteoarticular tuberculosis: increasing incidence of a difficult clinical diagnosis. Br J Gen Pract. ...

ADDITIONAL READING

  • Abdulaziz  S, Almoallim  H, Ibrahim  A, et al. Poncet's disease (reactive arthritis associated with tuberculosis): retrospective case series and review of...

CODES

ICD10

  • M00.9 Pyogenic arthritis, unspecified

  • A18.02 Tuberculous arthritis of other joints

  • M00.80 Arthritis due to other bacteria, unspecified joint

  • B49 Unspecified mycosis

  • M06.9 Rheumatoid arthritis, ...

CLINICAL PEARLS

  • Infectious arthritis may present as fever of unknown origin.

  • Fungal joint infection may present with synovial thickening and tenderness. Erythema and pain may not be present.

  • Spinal TB c...

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