Delayed Reimplantation Arthroplasty for Candidal Prosthetic Joint Infection: A Report of 4 Cases and Review of the Literature

Fungal prosthetic joint infection (PJI) is rare, with Candida species being the most frequently reported pathogen in the medical literature. The risk of relapse following delayed reimplantation arthroplasty for candidal PJI is unknown. We describe 4 new cases and summarize 6 previously reported case...

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Bibliographic Details
Published in:Clinical infectious diseases 2002-04, Vol.34 (7), p.930-938
Main Authors: PHELAN, David M, OSMON, Douglas R, KEATING, Michael R, HANSSEN, Arlen D
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antifungals
Arthroplasty
Arthroplasty - adverse effects
Biological and medical sciences
Candidiasis - epidemiology
Candidiasis - etiology
Candidiasis - microbiology
Candidiasis - therapy
Cements
Female
Human mycoses
Humans
Infections
Infectious diseases
Joint Diseases - epidemiology
Joint Diseases - etiology
Joint Diseases - microbiology
Joint Diseases - therapy
Joint prostheses
Knee replacement arthroplasty
Knees
Major Articles
Male
Medical sciences
Middle Aged
Mycoses
Mycoses of the osteoarticular system
Predisposing factors
Prosthesis-Related Infections - epidemiology
Prosthesis-Related Infections - etiology
Prosthesis-Related Infections - microbiology
Prosthesis-Related Infections - therapy
Prosthetics
Replantation
Retrospective Studies
Treatment Outcome
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Description
Summary:Fungal prosthetic joint infection (PJI) is rare, with Candida species being the most frequently reported pathogen in the medical literature. The risk of relapse following delayed reimplantation arthroplasty for candidal PJI is unknown. We describe 4 new cases and summarize 6 previously reported cases of candidal PJI treated with delayed reimplantation arthroplasty. Ninety percent of the patients received antifungal therapy. Eight patients received amphotericin B either alone or in combination with other antifungals. One patient received fluconazole alone. The median duration of time from resection arthroplasty to reimplantation for total hip and total knee arthroplasties was 8.6 and 2.3 months, respectively. Eight patients did not have relapse of candidal PJI following delayed reimplantation arthroplasty after a median duration of follow-up of 50.7 months (range, 2-73 months). Candidal PJI can be successfully treated with delayed reimplantation arthroplasty after receipt appropriate antifungal therapy.
ISSN:1058-4838
1537-6591
DOI:10.1086/339212