Fungal Infection of Native Hip Joint Presenting as Secondary Arthritis in 52-Year-Old Male - A Rare Case Report

Fungal infections of native joints are exceedingly rare and often present with non-specific symptoms, making diagnosis challenging. Hip involvement is particularly uncommon and may mimic tuberculosis or bacterial septic arthritis. Patients on long-term hemodialysis are at increased risk due to their immunocompromised state and repeated vascular access.

We present the case of a 52-year-old male with chronic kidney disease on maintenance hemodialysis for 5 years, who developed progressive left hip pain and functional limitation over 18 months. Radiological evaluation revealed destructive arthritis. He underwent a two-stage procedure: Initial debridement with insertion of an antibiotic cement spacer, during which intra-operative cultures yielded Candida guilliermondii. The patient received six weeks of intravenous Caspofungin. After normalisation of inflammatory markers, a second-stage total hip replacement was performed. Post-operatively, the patient achieved independent ambulation with significant pain relief and improved hip function.

Candida guilliermondii infection of the native hip in dialysis-dependent patients is exceptionally rare. Early diagnosis with culture confirmation, followed by antifungal therapy and staged surgical management, is critical for optimal functional recovery.