Sporotrichal arthritis in South Central Kansas

Sporotrichal arthritis is a rare disease, with only 51 cases reported in the English literature. Thirteen patients with sporotrichal arthritis have been treated at Wichita area hospitals since 1979. Most of the patients were middle aged men. Significant alcohol intake was noted in 77% of the patients. There were 17 joints involved in the cases, including 10 knees, three interphalangeal joints, one elbow, one midtarsal, one intercarpal, and one metatarsophalangeal joint. The typical appearance was an afebrile patient with a mildly swollen warm joint without erythema. The leukocyte counts were normal in 85% of patients, and the erythrocyte sedimentation rates were elevated in 100%. The patients had various treatments and responses. Response rates included intravenous amphotericin B (16%), ketoconazole (40%), and arthrodesis (100%). Sporotrichal arthritis may he more common than previously thought. It should he considered early in the differential diagnosis of monoarthritis.