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Updated: Aug 22, 2025

Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
Published on: February 2, 2024
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.
Abstract:
Prosthetic joint infections (PJIs) caused by fungi, although relatively rare, represent a major surgery-related complication. An extremely rare fungal PJI, following revised total knee replacement (TKR) caused by Candida lusitaniae, is reported, and a meticulous review of similar cases is provided. A 74-year-old female, who underwent primary total knee arthroplasty 10 years ago and a revision surgery three weeks ago, presented with signs and symptoms of PJI. C. lusitaniae was eventually isolated from the periprosthetic tissue using the MALDI-TOF VitekMS-bioMérieux technique. Multiple strategies for managing this fungal PJI were performed, and finally, the patient was treated successfully with an intramedullary arthrodesis system and proper antifungal treatment, including fluconazole. A multidisciplinary approach is essential for the diagnosis and treatment of such severe infections. In persistent cases and in cases where revision surgery is extremely difficult to perform, arthrodesis seems to be an effective solution for the elimination of the infection. The efficacy of the therapeutic management of fungal PJIs remains unclear. Therefore, more research should be reported, focusing on proper treatment so that the optimal strategy in treating these severe infections may be established.
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.
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