Disseminated Coccidioidomycosis of the Knee Joint Requiring Synovectomy and Arthrotomy

Abstract BackgroundThis article presents a case of an immunocompetent patient from an endemic area diagnosed with disseminated coccidioidomycosis of the knee joint, which was unusually severe and required operative management.Case presentationA 49-year-old patient with a history of pulmonary coccidiomyocosis presented with right knee pain and multiple symptomatic abscesses beneath the suprapatellar and infrapatellar fat pads. Arthocentesis and culture confirmed the infection, and open synovectomy, arthrotomy and drainage of the infection was performed without complication.ConclusionsDisseminated coccidioidomycosis is an uncommon fungal infection that may involve joints and become refractory to pharmacotherapy. Management may require surgical intervention along with infectious disease consultation and close follow-up. Patients from endemic regions should be evaluated with a comprehensive history for this disease.