A 46-year-old man presented with swelling and pain in the right knee and a history of nonproductive cough and weight loss. Sporotrichum schenkii was cultured from synovium, synovial fluid, sputum, and bronchial washings. No other pathogens were cultured. Neither skin lesions nor history of exposure to S. schenckii was present, but 7 years before this admission the patient had been treated for suspected pulmonary tuberculosis despite negative mycobacteriology. The case is believed to represent systemic spread from chronic pulmonary sporotrichosis and supports the hypothesis that the lung may serve as a portal of entry in noncutaneous systemic sporotrichosis.