Non-<i>Candida</i> Fungal Prosthetic Joint Infections
Background: Fungal prosthetic joint infections (PJIs) are rare, especially those caused by non-<i>Candida</i> species. Treatment has not been fully elucidated, since a plethora of antifungal and surgical interventions have been proposed. Τhis study represents an effort to clarify the opt...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/8/1410 |
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| author | Christos Koutserimpas Ifigeneia Chamakioti Stylianos Zervakis Konstantinos Raptis Kalliopi Alpantaki Diamantis P. Kofteridis Georgia Vrioni George Samonis |
| author_facet | Christos Koutserimpas Ifigeneia Chamakioti Stylianos Zervakis Konstantinos Raptis Kalliopi Alpantaki Diamantis P. Kofteridis Georgia Vrioni George Samonis |
| author_sort | Christos Koutserimpas |
| collection | DOAJ |
| description | Background: Fungal prosthetic joint infections (PJIs) are rare, especially those caused by non-<i>Candida</i> species. Treatment has not been fully elucidated, since a plethora of antifungal and surgical interventions have been proposed. Τhis study represents an effort to clarify the optimal management of non-<i>Candida</i> fungal PJIs, by reviewing all relevant published cases. Methods: A thorough review of all existing non-<i>Candida</i> fungal PJIs in the literature was conducted. Data regarding demographics, responsible organisms, antifungal treatment (AFT), surgical intervention, time between initial arthroplasty and onset of symptoms, and time between onset of symptoms and firm diagnosis, as well as the infection’s outcome, were evaluated. Results: Forty-two PJIs, in patients with mean age of 66.2 years, were found and reviewed. <i>Aspergillus</i> spp. were isolated in most cases (10; 23.8%), followed by <i>Coccidioides</i> spp. (7; 16.7%) and <i>Pichia</i><i>anomala</i> (5; 11.9%). Fluconazole was the preferred antifungal regimen (20 cases; 47.6%), followed by amphotericin B (18 cases; 42.9%), while the mean AFT duration was 9.4 months (SD = 7.06). Two-stage revision arthroplasty (TSRA) was performed in 22 cases (52.4%), with the mean time between stages being 5.2 months (SD = 2.9). The mean time between initial joint implantation and onset of symptoms was 42.1 months (SD = 50.7), while the mean time between onset of symptoms and diagnosis was 5.8 months (SD = 14.3). Conclusions: Non-<i>Candida</i> fungal PJIs pose a clinical challenge, demanding a multidisciplinary approach. The present review has shown that combination of TSRA separated by a 3–6-month interval and prolonged AFT has been the standard of care in the studied cases. |
| first_indexed | 2024-03-10T08:53:48Z |
| format | Article |
| id | doaj.art-9aaa7016368c4df586d0b7dbf67173f7 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T08:53:48Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-9aaa7016368c4df586d0b7dbf67173f72023-11-22T07:20:06ZengMDPI AGDiagnostics2075-44182021-08-01118141010.3390/diagnostics11081410Non-<i>Candida</i> Fungal Prosthetic Joint InfectionsChristos Koutserimpas0Ifigeneia Chamakioti1Stylianos Zervakis2Konstantinos Raptis3Kalliopi Alpantaki4Diamantis P. Kofteridis5Georgia Vrioni6George Samonis7Department of Orthopaedics and Traumatology, “251” Hellenic Air Force General Hospital of Athens, 115 25 Athens, GreeceEmergency Department, “251” Hellenic Air Force General Hospital of Athens, 115 25 Athens, GreeceDepartment of Cardiology, University Hospital of Heraklion, 714 09 Heraklion, GreeceDepartment of Orthopaedics and Traumatology, “251” Hellenic Air Force General Hospital of Athens, 115 25 Athens, GreeceDepartment of Orthopaedics and Traumatology, “Venizeleion” General Hospital of Heraklion, 714 09 Heraklion, GreeceDepartment of Internal Medicine, University Hospital of Heraklion, 715 00 Heraklion, GreeceDepartment of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, GreeceDepartment of Internal Medicine, University Hospital of Heraklion, 715 00 Heraklion, GreeceBackground: Fungal prosthetic joint infections (PJIs) are rare, especially those caused by non-<i>Candida</i> species. Treatment has not been fully elucidated, since a plethora of antifungal and surgical interventions have been proposed. Τhis study represents an effort to clarify the optimal management of non-<i>Candida</i> fungal PJIs, by reviewing all relevant published cases. Methods: A thorough review of all existing non-<i>Candida</i> fungal PJIs in the literature was conducted. Data regarding demographics, responsible organisms, antifungal treatment (AFT), surgical intervention, time between initial arthroplasty and onset of symptoms, and time between onset of symptoms and firm diagnosis, as well as the infection’s outcome, were evaluated. Results: Forty-two PJIs, in patients with mean age of 66.2 years, were found and reviewed. <i>Aspergillus</i> spp. were isolated in most cases (10; 23.8%), followed by <i>Coccidioides</i> spp. (7; 16.7%) and <i>Pichia</i><i>anomala</i> (5; 11.9%). Fluconazole was the preferred antifungal regimen (20 cases; 47.6%), followed by amphotericin B (18 cases; 42.9%), while the mean AFT duration was 9.4 months (SD = 7.06). Two-stage revision arthroplasty (TSRA) was performed in 22 cases (52.4%), with the mean time between stages being 5.2 months (SD = 2.9). The mean time between initial joint implantation and onset of symptoms was 42.1 months (SD = 50.7), while the mean time between onset of symptoms and diagnosis was 5.8 months (SD = 14.3). Conclusions: Non-<i>Candida</i> fungal PJIs pose a clinical challenge, demanding a multidisciplinary approach. The present review has shown that combination of TSRA separated by a 3–6-month interval and prolonged AFT has been the standard of care in the studied cases.https://www.mdpi.com/2075-4418/11/8/1410fungal infectionprosthetic joint infection<i>Aspergillus</i> spp.<i>Coccidioides</i> spp.<i>Pichia</i> spp.arthroplasty |
| spellingShingle | Christos Koutserimpas Ifigeneia Chamakioti Stylianos Zervakis Konstantinos Raptis Kalliopi Alpantaki Diamantis P. Kofteridis Georgia Vrioni George Samonis Non-<i>Candida</i> Fungal Prosthetic Joint Infections Diagnostics fungal infection prosthetic joint infection <i>Aspergillus</i> spp. <i>Coccidioides</i> spp. <i>Pichia</i> spp. arthroplasty |
| title | Non-<i>Candida</i> Fungal Prosthetic Joint Infections |
| title_full | Non-<i>Candida</i> Fungal Prosthetic Joint Infections |
| title_fullStr | Non-<i>Candida</i> Fungal Prosthetic Joint Infections |
| title_full_unstemmed | Non-<i>Candida</i> Fungal Prosthetic Joint Infections |
| title_short | Non-<i>Candida</i> Fungal Prosthetic Joint Infections |
| title_sort | non i candida i fungal prosthetic joint infections |
| topic | fungal infection prosthetic joint infection <i>Aspergillus</i> spp. <i>Coccidioides</i> spp. <i>Pichia</i> spp. arthroplasty |
| url | https://www.mdpi.com/2075-4418/11/8/1410 |
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