Fungal prosthetic joint infection in total hip or knee arthroplasty: a retrospective single-centre study of 26 cases.
Bone Joint J
; 101-B(5): 589-595, 2019 05.
Article
in En
| MEDLINE
| ID: mdl-31038988
ABSTRACT
AIMS:
Fungal prosthetic joint infections (PJIs) are rare and account for about 1% of total PJIs. Our aim was to present clinical and microbiological results in treating these patients with a two-stage approach and antifungal spacers. PATIENTS ANDMETHODS:
We retrospectively reviewed our institutional database and identified 26 patients with positive fungal cultures and positive Musculoskeletal Infection Society (MSIS) criteria for PJI who were treated between 2009 and 2017. We identified 18 patients with total hip arthroplasty (THA) and eight patients with total knee arthroplasty (TKA). The surgical and antifungal treatment, clinical and demographic patient data, complications, relapses, and survival were recorded and analyzed.RESULTS:
The median follow-up was 33 months. The success rate was 38.5% (10/26). Fluconazole resistance was found in 15%. Bacterial co-infection was common in 44% of patients for THA and 66% of patients with TKA. Mortality, reoperations, and treatment failure were common complications.CONCLUSION:
Treatment with a two-stage exchange is a possible option for treatment, although fungal infections have a high failure rate. Therapeutic factors for treatment success remain unclear. Cite this article Bone Joint J 2019;101-B589-595.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prosthesis-Related Infections
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Arthroplasty, Replacement, Hip
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Arthroplasty, Replacement, Knee
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Mycoses
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Antifungal Agents
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
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Humans
/
Middle aged
Language:
En
Journal:
Bone Joint J
Year:
2019
Document type:
Article
Affiliation country:
Germany