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Arthritis und Rheuma 2005; 25(02): 77-86
DOI: 10.1055/s-0037-1618493
Rheuma und Infektion
Schattauer GmbH

Arthritis bei Pilzerkrankungen

FungusarthritidenFungal arthritis
Gerhard L. Bach
1   Praxis für Innere Medizin und Rheumatologie, Grünstadt
,
Hans R. Müller-Faßbender
2   Praxis für Innere Medizin und Rheumatologie, Bad Abbach
› Author Affiliations
Further Information

Publication History

Publication Date:
23 December 2017 (online)

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Zusammenfassung

Pilzinfektionen gehören in der klinischen Praxis nicht selten zu differenzialdiagnostischen Problemfällen. Ein Grund dafür ist das häufige Fehlen charakteristischer Symptome im Frühstadium. Dazu kommen noch Schwierigkeiten des spezifischen Erregernachweises. Pilzinfektionen können osteoartikuläre Erkrankungen verursachen, deren zu späte Erkennung zu bleibender Schädigung der Gelenke und ihrer Funktion führt. Allerdings kommen Pilzarthritiden nicht oft vor.

Zu den häufigsten Fungusarthritiden zählen: Candidiasis, Kokzidioidomykose, Blastomykose und Sporotrichose. Seltenere Verursacher von Arthritiden sind Histoplasmose, Kryptokokkose und Aspergillose. Noch seltenere Pilzarthritiden gewinnen mit Zunahme von Immunschwächen an Bedeutung.

Verschiedene auslösende Faktoren, auch als Risikofaktoren bezeichnet, spielen bei der Entstehung von Pilzinfektionen und/oder Fungusarthritiden eine bedeutende Rolle. Es handelt sich dabei meistens um Krankheiten oder Formen der Behandlung, die eine Immunschwäche verursachen. Hierzu gehören Alkoholkrankheit, Leberzirrhose, Diabetes mellitus, Tuberkulose, Neoplasien, Organtransplantationen, AIDS (Acquired Immune Deficiency Syndrome) und Medikamente wie Kortikosteroide, Immunsuppressiva und neuerdings TNF-alpha-Blocker. Alle diese Risikofaktoren können zur Schwächung des Immunsystems beitragen und die Aussaat einer Pilzinfektion verursachen.

Summary

Fungal infections are among those not readily recognized differential diagnostic problems. The causative organism of most fungal infections is not easy to be demonstrated. Fungal infections can trigger chronic bone and joint disease whose late diagnosis may result in permanent damage to the joint and its function. Certainly, fungal arthritis is not so frequent.

The most common fungal arthritides are considered to be Candidiasis, Coccidioidomycosis, Blastomycosis, and Sporotrichosis. Less frequent causes are Histoplasmosis, Cryptococcosis and Aspergillosis followed by some very rare fungal joint manifestations with the increasingly failing immune response.

Various predisposing factors (risk factors) have been implicated in a majority of patients developing fungal infections and/or fungal arthritis. Alcoholism, cirrhosis of the liver, diabetes mellitus, tuberculosis, cancer, organ transplants, AIDS (Acquired Immune Deficiency Syndrome), and drugs like corticosteroids, immunosuppressive substances, and tumor necrosis factor alpha inhibitors are known to suppress the immune response. They play an important role in the dessimination of fungal infections.

Schlüsselwörter

Pilzinfektionen (Fungusinfektionen) - Pilzarthritis (Fungus-arthritis)

Keywords

Fungal infections - fungal arthritis
 

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