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Cryptococcal Meningitis

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...

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Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction

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Cryptococcus magnus Periprosthetic Shoulder Infection: A Case Report.

Mário Baptista¹, Nuno Sevivas^2,3, Nuno Vieira Ferreira^2,4

¹Orthopaedic Surgery and Traumatology Department, Hospital de Braga, Braga, Portugal.

JBJS Case Connector

|January 29, 2021

Summary

This case study details the first periprosthetic shoulder infection caused by Cryptococcus magnus in a diabetic patient. Successful treatment involved antifungal medications, highlighting a rare fungal pathogen in prosthetic joint infections.

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Area of Science:

Infectious Diseases
Mycology
Orthopedic Surgery

Background:

Periprosthetic joint infections (PJIs) are serious complications following orthopedic procedures.
While bacterial infections are common, fungal PJIs are rare and pose diagnostic and therapeutic challenges.
Cryptococcus species are known pathogens, but osteoarticular infections are infrequently reported.

Observation:

A 68-year-old diabetic male developed a periprosthetic shoulder infection (PSI) 4 weeks post-revision surgery.
The infection was identified as Cryptococcus magnus, a yeast not previously associated with osteoarticular infections.
The patient had a history of chronic bacterial PSI before the fungal diagnosis.

Findings:

This represents the first reported case of a periprosthetic shoulder infection caused by Cryptococcus magnus.
Previous reports of Cryptococcus-related PJIs primarily involved Cryptococcus neoformans.
Successful treatment was achieved with a combination of liposomal amphotericin B and fluconazole.

Implications:

This case expands the spectrum of fungal pathogens implicated in periprosthetic joint infections.
It underscores the importance of considering fungal etiologies in recalcitrant or unusual prosthetic infections.
Early and accurate diagnosis of fungal PSI is crucial for effective management and improved patient outcomes.