A case of H.capsulatum septic arthritis
Histoplasma capsulatum variety capsulatum (H.capsulatum) is a thermally dimorphic. Of the hundreds of thousands of patients exposed to this fungus, less than 1% develops severe illness most commonly manifesting as pulmonary disease.

Septic arthritis from hematogenous seeding with H.capsulatum or from direct inoculation has been rarely reported in the literature. Published in the International Journal of Infectious Diseases, the authors present the first case of septic arthritis of the shoulder due to H.capsulatum in an immunocompromised patient that has been successfully treated with irrigation and debridement, systemic antifungals and local delivery of amphotericin B with cement beads.

Importantly, the addition of local amphotericin B delivery by cement beads to conventional treatment likely lead to clinical cure in this patient.

Highlights of the case:-
• Bone and joint infections due to Histoplasma capsulatum variety capsulatum are rare.

• Patients on methotrexate for Rheumatoid arthritis may get H.capsulatum infections

• H.capsulatum septic arthritis of the shoulder is rare (common site is the knee)

• Patients failing debridement and antifungals require local antifungal delivery

Read about the case in detail here: https://www.ijidonline.com/article/S1201-9712(18)34541-7/pdf