Fungal Infection following Total Elbow Arthroplasty

Ornell, Samuel S.; Dang, Khang H.; Bois, Aaron J.; Dutta, Anil K.

doi:10.1155/2019/7927914

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…A total of 63 studies on fungal PJI were found. A total of 372 fungal PJI cases were retrieved, most of which were collected from case reports [ 12 , 14 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ], small case series [ 15 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ...…”

Section: Resultsmentioning

confidence: 99%

Epidemiology of Fungal Periprosthetic Joint Infection: A Systematic Review of the Literature

et al. 2022

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Fungal prosthetic joint infection (fPJI) is a rare complication; nonetheless, it represents a significant diagnostic and therapeutic challenge. There are no official guidelines on the most effective approach to identify and treat fPJIs. This systematic review aims to review the current literature on fPJI management and provide a comprehensive overview of this topic, especially from an epidemiologic point of view. Studies eligible for this systematic review were identified through an electronic systematic search of PubMed, Scopus, and Web of Science until 30 September 2022. Further references were obtained by cross-referencing. Sixty-three studies met the inclusion criteria, reporting on 372 cases of fPJI; such cases were described mostly in case reports and small case series with only a few larger cohort studies. Diagnosis of fPJI is challenging because of its chronic and indolent clinical course; it is further complicated by the technical difficulty of harvesting fungal cultures. A two-stage revision was the primary procedure in 239 (64.2%) patients whereas DAIR and one-stage approaches were reported in 30 (8.0%) and 18 (4.8 %) cases. In conclusion, our study highlights the heterogeneity of the reported treatments of fPJI, particularly in terms of medical management. With concern to a surgical approach, a two-stage revision arthroplasty is generally suggested, considering fPJI a delayed or late infection. The need for multicenter, prospective studies to provide standardized protocols and improve the treatment of fungal PJI clearly emerges.

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Section: Resultsmentioning

confidence: 99%

Epidemiology of Fungal Periprosthetic Joint Infection: A Systematic Review of the Literature

et al. 2022

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“…Most cases exhibit subtle inflammatory symptoms, [33] while only a few present as acute infections that can be diagnosed in the early stage. [34][35][36][37][38][39] Initial diagnostic tools for fPJI include ESR and CRP, as serum inflammatory biomarkers are easily accessible worldwide, cost-effective, and can be routinely performed preoperatively. These markers can serve as the first indicators for PJI in the absence of clinical signs.…”

Section: Diagnosismentioning

confidence: 99%

Efficacy of DAIR in managing Candida parapsilosis-infected total knee arthroplasty with five-year follow-up: A case report and review of literature

Li,

Fan,

Zhang

et al. 2023

Medicine

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Rationale: Fungal periprosthetic joint infections (fPJIs) are relatively uncommon, accounting for approximately 1% of all PJIs. Revision surgery is typically recommended for fungal infections; however, the physical and financial impact on patients is significant. In this report, we present a case of fPJI successfully treated with debridement, antibiotics, and implant retention (DAIR) with a favorable outcome over a 5-year period. Patient Concern: A 56-year-old male patient presented with a non-healing surgical incision 1 week after undergoing primary total knee arthroplasty on the right side. Diagnosis: Microbiological culture of the wound effusion identified Candida parapsilosis. Postoperatively, the patient exhibited a significant decrease in serum albumin levels and poor glycemic control. Both C-reactive protein and erythrocyte sedimentation rate were elevated. Interventions: A comprehensive DAIR procedure was performed, along with continuous closed irrigation using fluconazole for 1 week. The patient received intravenous voriconazole for 4 weeks, followed by oral fluconazole for an additional 3 months. Outcomes: At 1- and 5-year follow-up appointments, the patient C-reactive protein and erythrocyte sedimentation rate levels were within normal limits, and there was no evidence of swelling, erythema, or tenderness in the right knee joint, indicating no signs of infection. Lessons: DAIR is an effective treatment for early fPJIs, and continuous closed irrigation may provide specific advantages. The patient nutritional status plays a crucial role in the management of periprosthetic infections.

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Fungal Infection following Total Elbow Arthroplasty

Cited by 2 publications

References 14 publications

Epidemiology of Fungal Periprosthetic Joint Infection: A Systematic Review of the Literature

Epidemiology of Fungal Periprosthetic Joint Infection: A Systematic Review of the Literature

Efficacy of DAIR in managing Candida parapsilosis-infected total knee arthroplasty with five-year follow-up: A case report and review of literature

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