Arthritis, Infectious, Granulomatous
- Invasion of joints by microorganisms; often as part of a systemic infection/disease
- Curable type of arthritis
- System(s) affected: musculoskeletal
- Synonym(s): fungal arthritis; mycobacterial arthritis; subacute bacterial arthritis
- 1–3% of patients with tuberculosis (TB) infections (1)
- 10–30% of extrapulmonary TB presents with musculoskeletal involvement.
- Predominant age: all ages
- Predominant gender
- Male > female (Brucella and Mycobacterium)
- Female > male (fungal)
1 in 3 million in the general population
Infrequent in pediatric population
Etiology and Pathophysiology
- Hematogenous invasion is most common.
- Contiguous spread
- Direct penetration via trauma
- Fungal infections may disseminate from primary pulmonary involvement, particularly in immunocompromised hosts.
- Direct contact with or consumption of infected animal products
- Concurrent extra-articular infection
- Chronic inflammatory arthritis (e.g., rheumatoid arthritis [RA])
- Trauma, especially penetrating
- Prosthetic joint(s)
- Prior antibiotic, corticosteroid, or immunosuppressive therapy
- Serious chronic systemic illness (e.g., diabetes mellitus, liver disease, malignancy, primary immunodeficiency)
- Defective phagocytosis (e.g., chronic granulomatous disease)
- Injection drug use
- Exposure to specific infectious agents (e.g., brucellosis, unpasteurized milk, farmers, butchers, veterinarians)
- Gardening (sporotrichosis)
- Aquatic exposure (e.g., fish hook puncture and Mycobacterium marinum)
Commonly Associated Conditions
- Systemic infection
- Immunodeficiency/immunosuppression (e.g., from HIV/AIDS, lymphoma, transplantation, medications)
- Poncet disease (reactive arthritis associated with TB)
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Domino, Frank J., et al., editors. "Arthritis, Infectious, Granulomatous." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688765/all/Arthritis__Infectious__Granulomatous.
Arthritis, Infectious, Granulomatous. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688765/all/Arthritis__Infectious__Granulomatous. Accessed May 30, 2023.
Arthritis, Infectious, Granulomatous. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688765/all/Arthritis__Infectious__Granulomatous
Arthritis, Infectious, Granulomatous [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 May 30]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688765/all/Arthritis__Infectious__Granulomatous.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Arthritis, Infectious, Granulomatous ID - 1688765 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688765/all/Arthritis__Infectious__Granulomatous PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -