Prosthetic Knee Joint Infection Due to Candida lusitaniae: A Diagnostic and Therapeutic Odyssey: A Case Study

Vasileios Giovanoulis1, Angelo V Vasiliadis1,2, Christos Koutserimpas3

  • 1Orthopaedic Surgery and Sports Medicine Department, Croix-Rousse Hospital, Lyon University Hospital, 69007 Lyon, France.

Insights

This study reports a rare fungal prosthetic joint infection (PJI) caused by Candida lusitaniae after knee replacement surgery. Arthrodesis and antifungal treatment successfully managed the infection, highlighting the need for further research on fungal PJI therapies.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Mycology

Background:

  • Prosthetic joint infections (PJIs) are serious complications following joint replacement surgery.
  • Fungal PJIs are rare but pose significant treatment challenges.
  • Candida species are an uncommon cause of PJIs.

Observation:

  • A case of prosthetic knee joint infection caused by Candida lusitaniae following revision total knee replacement (TKR) is presented.
  • The patient, a 74-year-old female, presented with typical PJI symptoms.
  • Candida lusitaniae was identified using MALDI-TOF VitekMS-bioMérieux.

Findings:

  • Successful management of this rare fungal PJI was achieved through a combination of intramedullary arthrodesis and antifungal therapy (fluconazole).
  • Arthrodesis is presented as a viable alternative for infection eradication when revision surgery is complex.
  • A multidisciplinary approach is crucial for effective diagnosis and treatment.

Implications:

  • This case underscores the importance of considering fungal pathogens in PJI diagnosis.
  • Arthrodesis may be a valuable limb salvage option for intractable fungal PJIs.
  • Further research is needed to establish optimal treatment strategies for fungal PJIs to improve patient outcomes.