Blastomycosis presenting as monarticular arthritis. The role of synovial fluid cytology

✍ Scribed by Alfred L. George Jr.; J. Taylor Hays; Barney S. Graham

• Publisher: John Wiley and Sons
• Year: 1985
• Tongue: English
• Weight: 611 KB
• Volume: 28
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780280508

✦ Synopsis

Joint complaints are common among patients with blastomycosis; however, true arthritis is infrequently documented by synovial fluid analysis. Of 72 individuals with blastomycosis who were patients at the Vanderbilt School of Medicine affiliated hospitals during the period 1957-1983, 6 (8%) had arthritis at presentation. In 5 patients (7%), monarticular arthritis was the chief complaint leading to hospitalization. Cytologic examination of synovial fluid was performed in 4 patients and demonstrated characteristic organisms each time. Three patients had negative 10% potassium hydroxide smears, and 2 had negative synovial fluid cultures. Blastomycosis should be considered in the differential diagnosis of acute arthritis. In patients with blastomycotic arthritis, cytologic examination of synovi-a1 fluid can add to the diagnostic yield of synovial fluid fungal cultures and potassium hydroxide preparations.

Blastomycosis is a fungal infection caused by Blastomyces dermatitidis (1). The illness can affect multiple organs including lung, skin, bone, and genito-