Periprosthetic bacterial and fugal infection after total knee arthroplasty with one-stage debridement: a case report.

Publisher: BioMed Central Country of Publication: England NLM ID: 101293382 Publication Model: Electronic Cited Medium: Internet ISSN: 1752-1947 (Electronic) Linking ISSN: 17521947 NLM ISO Abbreviation: J Med Case Rep Subsets: MEDLINE

Original Publication: [London] : BioMed Central, [2007-

Arthroplasty, Replacement, Knee*/adverse effects ; Mycoses*; Female ; Humans ; Middle Aged ; Voriconazole ; Debridement ; Antifungal Agents/therapeutic use

Background: Periprosthetic infection is a serious complication after arthroplasty and is characterized by a long duration, recurrence, and a low cure rate. Although fungal infections are infrequent, they are often catastrophic, with an insidious onset, a long duration, atypical clinical symptoms, and imaging features in the early stage. They are easily misdiagnosed, or the diagnosis is missed, resulting in wrong treatment approaches.
Case Presentation: This paper reports a case involving a 62-year-old female patient of Korean ethnicity with a periprosthetic infection after knee arthroplasty who underwent joint debridement. A preoperative metagenomic next-generation sequencing of joint aspirate revealed Staphylococcus epidermidis. However, postsurgical tissue cultures confirmed the fungal infection. The patient received oral voriconazole and intra-articular injection of voriconazole for antifungal treatment. Since bacterial infection could not be ruled out, we also prescribed levofloxacin. No infection recurrence was observed after more than 22 months of follow-up. In the treatment of this patient, successful short-term follow-up was achieved, but long-term efficacy still cannot be determined.
Conclusions: In addition to the case study, we provide an analysis of the diagnosis and treatment of fungal infection after arthroplasty, especially the efficacy of debridement, antibiotics, and implant retention for a short-term outcome.
(© 2024. The Author(s).)

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Keywords: Complication; Debridement; Fungal infection; Knee arthroplasty

JFU09I87TR (Voriconazole)
0 (Antifungal Agents)

Date Created: 20240412 Date Completed: 20240415 Latest Revision: 20240425

20250114

PMC11015538

10.1186/s13256-024-04492-5

38610059