Knee swelling in a renal transplant recipient

Histoplasma knee infection in a renal transplant recipient has not been reported in the literature. The present case illustrates an interesting case of unilateral Histoplasma monoarthritis in a patient 3 years after renal transplantation who presented with pain and swelling of the right knee. The diagnosis was established by tissue aspiration from a focal lesion in lateral femur condyle. The patient was successfully managed with amphotericin followed by itraconazole with complete resolution of the symptoms. It is important to consider such rare differentials in an immunocompromised patient to avoid delays in treatment.