[Candida infection in hip alloarthroplasty]

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Medical Microbiology

Background:

• Necrosis of the femoral head necessitates total hip replacement (THR).
• Patients with polytoxicomania, diabetes, and polyneuropathy present complex comorbidities.
• Prosthetic joint infections (PJIs) are a significant complication following THR.

Observation:

• A 46-year-old polytoxicomanic patient developed a deep wound infection post-THR, initially involving Staphylococcus aureus, Enterococcus, and Candida parapsilosis.
• Despite multiple revision surgeries, antibiotics, and drainage, the infection persisted.
• Subsequent cultures after prosthesis removal and PMMA spacer insertion revealed Candida albicans.

Findings:

• Antifungal therapy with fluconazole eradicated Candida albicans infection.
• A staged revision involving a temporary spacer and subsequent prosthesis reimplantation was successful.
• The patient remained infection-free at the final follow-up.

Implications:

• This case demonstrates the successful management of a polymicrobial prosthetic joint infection with a specific focus on fungal eradication.
• Staged revision arthroplasty with appropriate antimicrobial therapy is a viable strategy for complex PJIs.
• The importance of thorough microbiological investigation and tailored treatment in recalcitrant infections is emphasized.