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Updated: Mar 1, 2026
Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
Published on: February 2, 2024
Candida Prosthetic Joint Infection. A Review of Treatment Methods
Fernando Cobo1, Javier Rodríguez-Granger1, Antonio Sampedro1
1Department of Microbiology, Hospital Virgen de las Nieves, Granada, Spain.
Abstract:
Fungal microorganisms are still a rare cause of bone and joint infections. We report a new case of knee prosthetic joint infection due to Candida albicans in a patient with a previous two-stage right knee arthroplasty for septic arthritis due to S. epidermidis occurred several months ago. Moreover, the treatment in 76 cases of Candida prosthetic joint infection has been discussed. Forty patients were female and mean age at diagnosis was 65.7 (± SD 18) yrs. No risk factors for candidal infection were found in 25 patients. Infection site was the knee in 38 patients and hip in 36; pain was present in 44 patients and swelling in 24. The most frequent species was C. albicans, followed by C. parapsilosis. Eleven patients were only treated with antifungal drugs being the outcome favourable in all of them. Two-stage exchange arthroplasty was performed in 30 patients, and resection arthroplasty in other 30; in three patients one-stage exchange arthroplasty was done. A favourable outcome was found in 58 patients after antifungal plus surgical treatment, in 11 after antifungal treatment alone and in one after surgery alone. The type of treatment is still not clearly defined and an algorithm for treatment in fungal PJI should be established, but various types of surgical procedures may be applied.
Insights
Fungal prosthetic joint infections (PJI) are rare. This study reviews 76 cases of Candida PJI, finding antifungal therapy combined with surgery offers favorable outcomes, though optimal treatment algorithms are needed.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Mycology
Background:
- Fungal infections, particularly Candida species, are uncommon causes of prosthetic joint infections (PJI).
- This study presents a case of knee PJI due to Candida albicans following previous arthroplasty and reviews existing literature on Candida PJI treatment.
Purpose of the Study:
- To investigate the characteristics and treatment outcomes of prosthetic joint infections caused by Candida species.
- To contribute to the understanding of optimal management strategies for fungal PJI.
Main Methods:
- A case report of Candida albicans knee PJI is presented.
- A literature review of 76 cases of Candida prosthetic joint infection was conducted.
- Treatment approaches including antifungal therapy and various surgical interventions were analyzed.
Main Results:
- Candida albicans was the most frequent species identified.
- Combined antifungal and surgical treatment yielded favorable outcomes in 58 patients.
- Antifungal therapy alone was successful in 11 patients, highlighting its potential role.
Conclusions:
- Fungal PJI requires a multidisciplinary approach, often involving both antifungal agents and surgical intervention.
- While combined therapy shows promise, further research is needed to establish clear treatment guidelines and algorithms for fungal PJI.
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