Fungal arthritis.

There are 50 000-200 000 species of fungi, but only about 100 of these cause infectious diseases (mycoses) in humans.' Fungal infections are not readily recognised, do not advertise their presence in a characteristic fashion, and the causative organism is generally not easy to demonstrate in tissue.2 Musculoskeletal infection by fungi was once rare, but its incidence has increased in the past few years. Although healthy subjects may host fungal diseases, various predisposing factors that depress the immune system have been implicated in most patients developing fungal infections or fungal arthritis, or both.3 Alcoholism, cirrhosis, diabetes, tuberculosis, cancer, prematurity, treatment with corticosteroids, cytotoxic drugs, prolonged use of intravenous antibiotics, intravenous drug abuse, granulocytopenia, and marrow hyperplasia are among the predisposing factors. Fungal arthritis usually follows a chronic indolent course of several months that leads to delays in diagnosis and to inappropriate treatment such as intra-articular and systemic steroids. Consequently, it is important to know the epidemiology and extra-articular manifestations of fungal disease to be aware of the possibility of musculoskeletal infection and to establish an appropriate treatment. The table gives the main characteristics of fungal arthritis.