Periprosthetic fungal infection of a hip caused by Trichosporon inkin

Area of Science:

• Medical Mycology
• Infectious Diseases
• Orthopedic Surgery

Background:

• Immunocompromised patients with orthopedic implants are susceptible to complex infections.
• Previous hip revisions and retained hardware increase infection risk.
• Empiric antibiotic treatment can mask or delay diagnosis of uncommon pathogens.

Observation:

• A patient with multiple hip revisions and a retained femoral rod presented with suspected infection.
• High index of suspicion for fungal etiology was crucial for diagnosis.
• Extended and specific fungal cultures identified Trichosporon inkin as the causative agent.

Findings:

• Surgical debridement with a vancomycin-and-voriconazole-supplemented cement spacer was performed.
• A 6-month course of systemic voriconazole was administered.
• The patient achieved a symptom-free status after 2 years of follow-up.

Implications:

• Early and specific diagnostic methods are vital for managing rare fungal implant infections.
• Multimodal treatment combining surgery and targeted antifungal therapy is effective.
• Successful management of Trichosporon inkin prosthetic joint infections is achievable in complex cases.