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August 11, 1978

Multiarticular Sporotrichosis

Author Affiliations

From the Department of Pathology, Hennepin County Medical Center (Drs Molstad and Strom), and the University of Minnesota (Dr Strom), Minneapolis.

JAMA. 1978;240(6):556-557. doi:10.1001/jama.1978.03290060058016

SPOROTRICHOSIS is an uncommon infection caused by a dimorphic fungus that typically produces a granulomatous skin ulcer followed by regional lymphadenopathy. Sporotrichosis presenting as arthritis without skin involvement is rare; only a few dozen cases have been reported.1-3 Most often, only one joint is involved and a history of trauma usually precedes the onset of arthritis.

Multiarticular sporotrichosis occurs mostly in persons whose bodily defenses are compromised by immunosuppression or malignant neoplasms.1 Lacking the characteristic skin findings, the disease is easily misdiagnosed as rheumatoid arthritis, tuberculous arthritis, or sarcoidosis, even after biopsy. Fortunately, fungal cultures clinch the correct diagnosis.

Report of a Case  A 34-year-old male alcoholic first came to us in May 1975 with a large, painful, suprapatellar effusion of the right knee. He also had a cyst of the left wrist and a psoriasiform rash of both legs. A biopsy specimen of the wrist cyst was