Conclusion
This case report aimed to record an unsuccessful attempt at treating a
case of fungal arthritis, highlighting the challenges faced and
emphasising the severity of this type of infection. The authors
emphasise the need for intensive treatment from the outset consisting of
arthroscopic debridement and synovial lavage of all pouches in
combination with systemic and local antifungal chemotherapy. This report
offers further data on the apparent safe use of IA antifungal
chemotherapeutics. Furthermore, the importance of synovial culture and
sensitivity is highlighted. Fungal septic arthritis should be considered
a differential diagnosis for atypical or unresponsive cases of synovial
sepsis. The prognosis for a return to athleticism is in the authors’
opinion poor and at best treatment is likely to be lengthy with human
colleagues reporting antifungal chemotherapeutic administration
continuing for more than 12 months in some cases(Fang et al.2019). There remains a significant void in the literature about fungal
arthritis in the horse, further research should focus on establishing
veterinary-specific breakpoints for fungal sensitivity and the
subsequent safe use of various anti-fungal chemotherapeutics.
Furthermore, a greater understanding of the risk factors and ensuing
pathology must be achieved.