Candida prosthetic infections: Case series and literature review

Dutronc, H.; Dauchy, F.-A.; Cazanave, Charles; Rougie, Catherine; Lafarie-Castet, S.; Couprie, B.; Fabre, Thierry; Dupon, M.

doi:10.3109/00365548.2010.498023

Cited by 76 publications

(63 citation statements)

References 44 publications

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“…Fever and a fistula are rare. 3,[9][10][11] The mean timespan between surgery and clinical signs is 21 months. …”

Section: Clinical Picturementioning

confidence: 99%

“…9,10 PCR might be an alternative, but is not proven yet. 10 We are unable to differentiate bacterial from fungal infections on systemic inflammatory markers and aspiration cell count.…”

Section: Diagnosismentioning

confidence: 99%

“…3,10,11,13 A diagnostic error is often made by saying it is only a contaminant, whereas it might be the reason for the patient's symptoms. 9,10,11 Kuiper et al 10 had 51% of their original cultures reported as possible contaminants but in the end 21% of them were falsely reported as contaminants.…”

Section: Diagnosismentioning

confidence: 99%

“…3,9,11,14 Currently we rely on the results of cultures from joint aspirations or tissue. It can be intra-operative tissue specimens or aspirations.…”

Section: Diagnosismentioning

confidence: 99%

“…However, it is so difficult to get a positive culture that any indication should rather be considered as being positive than a contaminant. 9,10 One study suggested that at least two positive cultures are needed. 2 Fungal infection is however so devastating that the tumour and sepsis specialist involved in this study acts on one positive culture.…”

Section: 1011mentioning

confidence: 99%

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Periprosthetic fungal infections: Be alert ( Clinical cases and review of the literature)

Botha¹,

Roux²,

McLoughlin³

2016

SA orthop. j.

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The increasing rate of arthroplasty, revisions and resistance to antibiotics has increased the risk for fungal infections. Fungal infections after joint replacements are rare but devastating. Different treatment modalities exist: suppressive therapy, debridement with retained prosthesis, Girdlestone procedures and 2-or even 3-stage revision arthroplasty. The aim of the review is to guide the surgeon with regard to a protocol to address fungal infections. AbstractThe increasing rate of arthroplasty, revisions and resistance to antibiotics has increased the risk for fungal infections. Different treatment modalities exist: suppressive therapy, debridement with retained prosthesis, Girdlestone procedures and 2-or even 3-stage revision arthroplasty. Fungal infections after joint replacements are rare but devastating. Purpose of the study:The aim was to see if there was any trend that could help with the diagnosis and management of patients with fungal infections. The literature was reviewed in order to assist with diagnosis and treatment. Materials and methods:A retrospective study was performed and all the cases seen and treated by a tumour and sepsis orthopaedic specialist from 1999 to 2015 were evaluated. Inclusion criteria: Patients had to be diagnosed with a fungal infection in any specimen which was sent for histology or culture. Exclusions: none.Results: Four patients were identified. All of them were males. Mean age 58 (35-71) years. The primary surgical indications were: vertebral osteomyelitis; post primary knee replacement; pig bite with lower limb sepsis and osteoarthritis knee, and a septic total hip replacement. Three cases cultured Candida parapsilosis and one Candida albicans of which three were tissue cultures and one a blood culture.Currently 75% have failed treatment -one passed away, one developed systemic sepsis, and one had an above-knee amputation and is still struggling with subsequent bacterial infections in the amputation stump. Conclusion:As long as there are higher incidences of fungal infections with devastating complications more evidence is needed. Numerous small case studies have been published, with the purpose of looking for the correct treatment: monotherapy, combination therapy, newer antifungals, higher dosages, implant retention or removal. It appears that the correct answer is unclear as yet.It is important to always have a high index of suspicion and good pre-operative planning together with a team approach: infectious diseases specialist, microbiologist and histologist. This approach will optimise the probability of making a diagnosis and to appropriately manage the fungus cultured.

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“…Fever and a fistula are rare. 3,[9][10][11] The mean timespan between surgery and clinical signs is 21 months. …”

Section: Clinical Picturementioning

confidence: 99%

“…9,10 PCR might be an alternative, but is not proven yet. 10 We are unable to differentiate bacterial from fungal infections on systemic inflammatory markers and aspiration cell count.…”

Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

“…3,9,11,14 Currently we rely on the results of cultures from joint aspirations or tissue. It can be intra-operative tissue specimens or aspirations.…”

Section: Diagnosismentioning

confidence: 99%

Section: 1011mentioning

confidence: 99%

See 3 more Smart Citations

Periprosthetic fungal infections: Be alert ( Clinical cases and review of the literature)

Botha¹,

Roux²,

McLoughlin³

2016

SA orthop. j.

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Microbiological Diagnosis of Implant-Related Infections: Scientific Evidence and Cost/Benefit Analysis of Routine Antibiofilm Processing

Drago

Vecchi

2016

Advances in Experimental Medicine and Biology

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Prosthetic joint infection is one of the most severe complication following joint arthroplasty, producing a significant worsening of patient's quality of life. Management of PJIs requires extended courses of antimicrobial therapy, multiple surgical interventions and prolonged hospital stay, with a consequent economic burden, which is thought to markedly increase in the next years due to the expected burden in total joint arthroplasties. The present review summarizes the present knowledge on microbiological diagnosis of prosthetic joint infections, focusing on aethiological agents and discussing pros and cons of the available strategies for their diagnosis.Intra-operative clinical diagnosis and pathogen identification is considered the diagnostic benchmark, however the presence of bacterial biofilm makes pathogen detection with traditional microbiological techniques highly ineffective. Diagnosis of PJIs is a rather complex challenge for orthopedics and requires a strict collaboration between different specialists: orthopaedics, infectivologists, microbiologists, pathologists and radiologists. Diagnostic criteria have been described by national and international association and scientific societies. Clinicians should be trained on how to use it, but more importantly they should know potential and limitation of the available tests in order to use them appropriately.

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Fungal Biofilms in Human Disease

Williams

Ramage

2014

Advances in Experimental Medicine and Biology

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Candida prosthetic infections: Case series and literature review

Cited by 76 publications

References 44 publications

Periprosthetic fungal infections: Be alert ( Clinical cases and review of the literature)

Periprosthetic fungal infections: Be alert ( Clinical cases and review of the literature)

Microbiological Diagnosis of Implant-Related Infections: Scientific Evidence and Cost/Benefit Analysis of Routine Antibiofilm Processing

Fungal Biofilms in Human Disease

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