Disseminated Coccidioidomycosis of the Knee Joint Requiring Synovectomy and Arthrotomy

INTRODUCTION: Coccidioidomycosis is a fungal infection endemic to the Southwestern United States, Mexico, and South America. While uncommon, inhalation of spores or direct cutaneous contact can lead to disseminated infection in the immunocompetent, with the involvement of the musculoskeletal and integumentary systems. CASE REPORT: A 49-year-old patient with a history of pulmonary coccidioidomycosis presented with the right knee pain and multiple symptomatic abscesses beneath the suprapatellar and infrapatellar fat pads. Arthrocentesis and culture confirmed the infection, and open synovectomy, arthrotomy, and drainage of the infection were performed without complication. CONCLUSION: Disseminated coccidioidomycosis is an uncommon fungal infection that may involve joints and become refractory to pharmacotherapy. Management may require surgical intervention, along with infectious disease consultation and close follow-up. Patients from endemic regions should be evaluated with a comprehensive history of this disease.