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The Journal of Bone and Joint Surgery (American) 83:1718-1722 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.

Case Report

Musculoskeletal Histoplasmosis

A Case Report and Review of the Literature

Joy M. Weinberg, BA, Raed Ali, MD, Sunil Badve, MD, MRC(Path) and Richard R. Pelker, MD, PhD

Investigation performed at Yale University School of Medicine, New Haven, Connecticut
Joy M. Weinberg, BA Raed Ali, MD Richard R. Pelker, MD, PhD Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, P.O. Box 208071, New Haven, CT 06520-8071
Sunil Badve, MD, MRC(Path) Department of Surgical Pathology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06511
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.


   Introduction
 
Histoplasmosis is an uncommon but not rare disease of fungal etiology that has infrequently been reported as occurring in the musculoskeletal system1-15. The diagnosis can be confused with sarcoidosis, tuberculosis, or a reactive inflammation. We report a case of histoplasmosis of the knee in a patient who had the human immunodeficiency virus.


   Case Report
 
A forty-year-old woman who had no history of trauma was seen with tenderness and effusion of four months’ duration in the right knee. She had also noted transient migratory arthralgias in the left knee and left foot during that time-period. However, the right knee was the only joint affected at the time of presentation. Her medical history included human immunodeficiency virus, diagnosed eleven years earlier; genital herpes simplex virus; polycystic kidney disease; and hypertension. Pulmonary histoplasmosis had been diagnosed eight months earlier and treated with oral itraconazole intermittently because of the patient’s noncompliance. The last CD4 count, . . . [Full Text of this Article]


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