Mucormycotic Polyarthritis in an Immunocompetent Patient

Mucormycosis is an infection caused by fungi of the order Mucorales, which includes the genera Mucor, Rhizopus, Rhizomucor, and Absidia. It is the third most common invasive fungal infection after candidiasis and aspergillosis1. Clinically, the disease often manifests with rhinocerebral, pulmonary, or cutaneous involvement. Arthritis due to mucormycosis is rare. To the best of our knowledge, only eight cases of mucormycotic arthritis have been reported in the literature: two were accompanied by human immunodeficiency virus (HIV) infection2,3, and the other six followed knee surgery4,5. All of these cases involved only one joint. We present a case of mucormycotic polyarthritis caused by Mucor species in an immunocompetent man. The patient was informed that data concerning the case would be submitted for publication, and he gave his consent. A forty-two-year-old male agricultural worker presented to our clinic with a two-week history of painful swelling of the right knee and right foot. He also reported that he had experienced mild pain and swelling in the anterior part of the chest for the previous two months. The medical history was notable only for the resection of a papillary thyroid carcinoma at the age of thirty-one. On physical examination, the patient was well nourished; his height was 168.7 cm, and his weight was 72.8 kg. The right knee was swollen, warm, and tender, with a positive patellar ballottement test. The dorsum of the right midfoot, the right sternoclavicular joint, and the right sternocostal joints were also slightly swollen and tender on palpation. On laboratory investigation, the white blood-cell count was 5400/mm3 (normal, 3000 to 7800/mm3), the hemoglobin cell count was 11.9 g/dL (normal, 10.6 to 14.4 g/dL), the C-reactive protein (CRP) level was 8.29 mg/dL (normal, 0.00 to 0.50 mg/dL), and the erythrocyte …