Semin Musculoskelet Radiol 2011; 15(5): 506-510
DOI: 10.1055/s-0031-1293496
© Thieme Medical Publishers

Musculoskeletal Fungal Infections

Peter D. Corr1
  • 1Department of Radiology, Faculty of Health Sciences, UAE University, Al Ain, United Arab Emirates
Further Information

Publication History

Publication Date:
11 November 2011 (online)


Fungal infections of the musculoskeletal system are uncommon. They are often found in immunosuppressed or patients with the acquired immunodeficiency syndrome or in patients with a history of travel to an endemic region. Infections often present with multifocal chronic osteomyelitis or chronic mono- or polyarthritis resembling osteoarticular tuberculosis. A clinical clue to the correct diagnosis is the presence of overlying skin sinuses. Radiologists can suggest the correct diagnosis with a good clinical history, although a biopsy and/or fungal culture is usually necessary before beginning treatment.


  • 1 Maertens J, Glasmacher A, Herbrecht R Caspofungin Combination Therapy Study Group et al. Multicenter, noncomparative study of caspofungin in combination with other antifungals as salvage therapy in adults with invasive aspergillosis.  Cancer. 2006;  107 (12) 2888-2897
  • 2 Marr K A. New approaches to invasive fungal infections.  Curr Opin Hematol. 2003;  10 (6) 445-450
  • 3 Mandal B. AIDS and fungal infections.  J Infect. 1989;  19 (3) 199-205
  • 4 Barnes P D, Marr K A. Risks, diagnosis and outcomes of invasive fungal infections in haematopoietic stem cell transplant recipients.  Br J Haematol. 2007;  139 (4) 519-531
  • 5 Holding K J, Dworkin M S, Wan P C et al.. Aspergillosis among people infected with human immunodeficiency virus: incidence and survival. Adult and Adolescent Spectrum of HIV Disease Project.  Clin Infect Dis. 2000;  31 (5) 1253-1257
  • 6 Ersoy A, Akdag I, Akalin H, Sarisozen B, Ener B. Aspergillosis osteomyelitis and joint infection in a renal transplant recipient.  Transplant Proc. 2007;  39 (5) 1662-1663
  • 7 Hummel M, Schüler S, Weber U et al.. Aspergillosis with aspergillus osteomyelitis and diskitis after heart transplantation: surgical and medical management.  J Heart Lung Transplant. 1993;  12 (4) 599-603
  • 8 Mekan S F, Saeed O, Khan J A. Invasive aspergillosis with polyarthritis.  Mycoses. 2004;  47 (11–12) 518-520
  • 9 Oppenheimer M, Embil J M, Black B et al.. Blastomycosis of bones and joints.  South Med J. 2007;  100 (6) 570-578
  • 10 Mahiquez M, Bunton K L, Carney G, Weinstein M A, Small J M. Nonsurgical treatment of lumbosacral blastomycosis involving L2-S1: a case report.  Spine. 2008;  33 (13) E442-E446
  • 11 Hadjipavlou A G, Mader J T, Nauta H J, Necessary J T, Chaljub G, Adesokan A. Blastomycosis of the lumbar spine: case report and review of the literature, with emphasis on diagnostic laboratory tools and management.  Eur Spine J. 1998;  7 (5) 416-421
  • 12 Güler N, Palanduz A, Ones U et al.. Progressive vertebral blastomycosis mimicking tuberculosis.  Pediatr Infect Dis J. 1995;  14 (9) 816-818
  • 13 Saccente M, Abernathy R S, Pappas P G, Shah H R, Bradsher R W. Vertebral blastomycosis with paravertebral abscess: report of eight cases and review of the literature.  Clin Infect Dis. 1998;  26 (2) 413-418
  • 14 Saiz P, Gitelis S, Virkus W, Piasecki P, Bengana C, Templeton A. Blastomycosis of long bones.  Clin Orthop Relat Res. 2004;  421 (421) 255-259
  • 15 Bradsher R W, Chapman S W, Pappas P G. Blastomycosis.  Infect Dis Clin North Am. 2003;  17 (1) 21-40 vii
  • 16 Yang S C, Shao P L, Hsueh P R, Lin K H, Huang L M. Successful treatment of Candida tropicalis arthritis, osteomyelitis and costochondritis with caspofungin and fluconazole in a recipient of bone marrow transplantation.  Acta Paediatr. 2006;  95 (5) 629-630
  • 17 Legout L, Assal M, Rohner P, Lew D, Bernard L, Hoffmeyer P. Successful treatment of Candida parapsilosis (fluconazole-resistant) osteomyelitis with caspofungin in a HIV patient.  Scand J Infect Dis. 2006;  38 (8) 728-730
  • 18 Ascherman D P, Cupps T R, Kumar P N. Isolated Candida albicans arthritis in a non-intravenous drug-abusing patient with acquired immune deficiency syndrome.  J Clin Rheumatol. 1997;  3 (1) 47-49
  • 19 Rovinsky D, Williams Jr G R, Iannotti J P, Ragsdale B D. Autoimmune arthritis caused by Candida septic arthritis.  J Shoulder Elbow Surg. 1995;  4 (6) 472-476
  • 20 Wascher D C, Hartman G P, Salka C, Mertz G J. Coccidiomycosis presenting as a popliteal cyst.  Arthroscopy. 1998;  14 (1) 99-102
  • 21 Chuck S L, Sande M A. Infections with Cryptococcus neoformans in the acquired immunodeficiency syndrome.  N Engl J Med. 1989;  321 (12) 794-799
  • 22 Magid D, Smith B. Cryptococcus neoformans osteomyelitis of the clavicle.  Orthopedics. 1992;  15 (9) 1068-1070
  • 23 Al-Tawfiq J A, Ghandour J. Cryptococcus neoformans abscess and osteomyelitis in an immunocompetent patient with tuberculous lymphadenitis.  Infection. 2007;  35 (5) 377-382
  • 24 Chand K, Lall K S. Cryptococcosis (torulosis, European blastomycosis) of the knee joint. A case report with review of the literature.  Acta Orthop Scand. 1976;  47 (4) 432-435
  • 25 Alam K, Maheshwari V, Bhargava S, Jain A, Fatima U, Haq E U. Histological diagnosis of madura foot (mycetoma): a must for definitive treatment.  J Glob Infect Dis. 2009;  1 (1) 64-67
  • 26 Corr P. Clinics in diagnostic imaging. Madura foot (or mycetoma).  Singapore Med J. 1997;  38 (6) 268-269
  • 27 Xavier M H, Teixeira AdeL, Pinto J M et al.. Cat-transmitted cutaneous lymphatic sporothricosis.  Dermatol Online J. 2008;  14 (7) 4
  • 28 Oliveira-Neto M P, Mattos M, Lazera M, Reis R S, Chicarino-Coelho J M. Zoonotic sporothricosis transmitted by cats in Rio de Janeiro, Brazil. A case report.  Dermatol Online J. 2002;  8 (2) 5
  • 29 Davis K A, Finger D R, Shparago N I. Disseminated histoplasmosis mimicking Felty's syndrome.  J Clin Rheumatol. 2002;  8 (1) 38-43
  • 30 Akinyoola A L, Onayemi O, Famurewa O C. African histoplasmosis—masquerading as a malignant bone tumour.  Trop Doct. 2006;  36 (4) 250-251
  • 31 Goel D, Prayaga A K, Rao N, Damodaram P. Histoplasmosis as a cause of nodular myositis in an AIDS patient diagnosed on fine needle aspiration cytology. A case report.  Acta Cytol. 2007;  51 (1) 89-91
  • 32 Liang K V, Ryu J H, Matteson E L. Histoplasmosis with tenosynovitis of the hand and hypercalcemia mimicking sarcoidosis.  J Clin Rheumatol. 2004;  10 (3) 138-142
  • 33 Wheat L J. Histoplasmosis: a review for clinicians from non-endemic areas.  Mycoses. 2006;  49 (4) 274-282

Peter D Corr, M.D. 

Department of Radiology, Faculty of Health Sciences, UAE University

P.O. Box 17666, Al Ain, United Arab Emirates

Email: [email protected]