Periprosthetic hip joint infection with Aspergillus terreus : A clinical case and a review of the literature

Bartash, Rachel; Guo, Yi; Pope, John B.; Levi, Michael H.; Szymczak, Wendy; Saraiya, Nidhi; Nori, Priya

doi:10.1016/j.mmcr.2017.07.006

Cited by 19 publications

(15 citation statements)

References 20 publications

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“…Although tissue was not sent for histopathology in our case, it is an important tool to define the diagnostic significance of positive culture results when contamination is suspected. Aspergillus terreus infections may produce high levels of serum galactomannan; however, serum galactomannan was negative in our case and the other PJI case reported in the literature due to A terreus [ 18 ]. This is likely because these infections are limited to the joint and are not disseminated.…”

Section: Discussioncontrasting

confidence: 64%

“…A review article on Aspergillus osteomyelitis (excluding septic arthritis and PJI) by Gamaletsou et al [ 16 ] demonstrated A terreus as the etiology of infection in only 3% (5 of 180) of the cases. There are only a handful of PJIs secondary to A terreus reported to date [ 14 , 17 , 18 ]. To the best of our knowledge, our case is the first case of a finger PJI secondary to A terreus .…”

Section: Discussionmentioning

confidence: 99%

“…Limited data are available for itraconazole, posaconazole, isavuconazole, or caspofungin. There are reports of cases successfully treated with posaconazole, whereas the resistance rate of A terreus to posaconazole in European countries was reported to be approximately 5% [ 18 , 23 ]. In our case, the patient was treated with voriconazole for 5 months with removal of the infected prosthesis and resolution of infection.…”

Section: Discussionmentioning

confidence: 99%

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Prosthetic Finger Joint Infection Due to Aspergillus terreus

Kobayashi

Lawler

Samra

et al. 2020

Open Forum Infectious Diseases

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prosthetic Finger Joint Infection Due to Aspergillus terreus

Kobayashi

Lawler

Samra

et al. 2020

Open Forum Infectious Diseases

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“…Stiles [ 7 ] or Aspergillus spp. [ 8 ], and in a small percentage of cases there may be a concomitant bacterial infection [ 3 ]. When the fungus encounters the implant surface, it develops a complex biofilm which displays potent resistance to antimicrobial therapy and protects the community of microbes from the immune response, which is the cause for the high persistence of the infection [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

A Biodegradable Antifungal-Loaded Sol–Gel Coating for the Prevention and Local Treatment of Yeast Prosthetic-Joint Infections

et al. 2020

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Fungal prosthetic-joint infections are rare but devastating complications following arthroplasty. These infections are highly recurrent and expose the patient to the development of candidemia, which has high mortality rates. Patients with this condition are often immunocompromised and present several comorbidities, and thus pose a challenge for diagnosis and treatment. The most frequently isolated organisms in these infections are Candida albicans and Candida parapsilosis, pathogens that initiate the infection by developing a biofilm on the implant surface. In this study, a novel hybrid organo–inorganic sol–gel coating was developed from a mixture of organopolysiloxanes and organophosphite, to which different concentrations of fluconazole or anidulafungin were added. Then, the capacity of these coatings to prevent biofilm formation and treat mature biofilms produced by reference and clinical strains of C. albicans and C. Parapsilosis was evaluated. Anidulafungin-loaded sol–gel coatings were more effective in preventing C. albicans biofilm formation, while fluconazole-loaded sol–gel prevented C. parapsilosis biofilm formation more effectively. Treatment with unloaded sol–gel was sufficient to reduce C. albicans biofilms, and the sol–gels loaded with fluconazole or anidulafungin slightly enhanced this effect. In contrast, unloaded coatings stimulated C. parapsilosis biofilm formation, and loading with fluconazole reduced these biofilms by up to 99%. In conclusion, these coatings represent a novel therapeutic approach with potential clinical use to prevent and treat fungal prosthetic-joint infections.

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“…Aspergillus terreus is a medically important pathogen associated with life-threatening states, ranging from cystic fibrosis, aspergillomas, spondylodiscitis, and periprosthetic hip-joint infection in immunocompetent hosts and lethal invasive disease in immunocompromised individuals. 1 – 4 An upsurge in the mortality rate of 74%–92% in transplant recipients suffering from invasive aspergillosis has been reported. 5 , 6 It is now understood that invasive aspergillosis sufferers often have higher incidence of cancer and organ transplantation, 7 an indication that Aspergillus infections could lead to sequential development of other diseases.…”

Section: Introductionmentioning

confidence: 99%

Invasive <em>Aspergillus terreus</em> morphological transitions and immunoadaptations mediating antifungal resistance

Louis¹,

Yekwa²,

Subhani³

et al. 2017

IDR

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Background and aimsAspergillus terreus Thom is a pathogen of public health and agricultural importance for its seamless abilities to expand its ecological niche. The aim of this study was holistically to investigate A. terreus morphological and immunoadaptations and their implication in antifungal resistance and proliferation during infection.Materials and methodsIn-depth unstructured mining of relevant peer-reviewed literature was performed for A. terreus morphological, immune, resistance, and genetic diversity based on the sequenced calmodulin-like gene.ResultsAccessory conidia and phialidic conidia produced by A. terreus confer discrete anti-fungal resistance that ensures survivability during therapies. Interestingly, by producing unique metabolites such as Asp–melanin and terretonin, A. terreus is capable of hijacking macrophages and scavenging iron, respectively. As such, A. terreus has established a rare mechanism to mitigate phagocytosis and swing the interaction dynamics in favor of its proliferation and survival in hosts.ConclusionIt is further unraveled that besides A. terreus genetic diversity, morphological, biochemical, and immunologic adaptations associated with conidia germination and discharge of chemical signals during infection enable masking of the host defense as an integral part of its strategy to survive and rapidly colonize hosts.

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Periprosthetic hip joint infection with Aspergillus terreus : A clinical case and a review of the literature

Cited by 19 publications

References 20 publications

Prosthetic Finger Joint Infection Due to Aspergillus terreus

Prosthetic Finger Joint Infection Due to Aspergillus terreus

A Biodegradable Antifungal-Loaded Sol–Gel Coating for the Prevention and Local Treatment of Yeast Prosthetic-Joint Infections

Invasive <em>Aspergillus terreus</em> morphological transitions and immunoadaptations mediating antifungal resistance

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