A spacer infection by Candida albicans secondary to a Staphylococcus capitis prosthetic joint infection: a case report
Abstract Background Prosthetic joint infection (PJI) is one of the most feared complications following total arthroplasty surgeries. Gram-positive bacteria are the most common microorganisms implicated in PJIs, while infections mediated by fungi only account for 1% of cases. When dealing with PJIs,...
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| Format: | Article |
| Language: | English |
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BMC
2021-05-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-021-06113-8 |
| _version_ | 1819298514570575872 |
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| author | Marta Bottagisio Alessandro Bidossi Nicola Logoluso Antonio Pellegrini Elena De Vecchi |
| author_facet | Marta Bottagisio Alessandro Bidossi Nicola Logoluso Antonio Pellegrini Elena De Vecchi |
| author_sort | Marta Bottagisio |
| collection | DOAJ |
| description | Abstract Background Prosthetic joint infection (PJI) is one of the most feared complications following total arthroplasty surgeries. Gram-positive bacteria are the most common microorganisms implicated in PJIs, while infections mediated by fungi only account for 1% of cases. When dealing with PJIs, a two-stage revision arthroplasty is widely used. Briefly, a spacer is introduced until re-implantation of the definitive prosthesis to provide skeleton stabilization while delivering antibiotics in the site of the infection. Sometimes, antimicrobial therapy may fail, but the isolation of a second microorganism from the spacer is uncommon and even less frequent that of a yeast. Case presentation Here is described a case of a 75-year-old woman who underwent two-stage revision surgery of the left hip prosthesis secondary to a Staphylococcus capitis infection, whose spacer was found to be infected by Candida albicans at a later time. Briefly, the patient underwent revision surgery of the hip prosthesis for a suspected PJI. After the debridement of the infected tissue, an antibiotic-loaded spacer was implanted. The microbiological analysis of the periprosthetic tissues and the implant depicted a S. capitis infection that was treated according to the antimicrobial susceptibility profile of the clinical isolate. Three months later, the patient was admitted to the emergency room due to local inflammatory signs. Synovial fluid was sent to the laboratory for culture. No evidence of S. capitis was detected, however, a yeast was identified as Candida albicans. Fifteen days later, the patient was hospitalized for the removal of the infected spacer. Microbiological cultures confirmed the results of the synovial fluid analysis. According to the susceptibility profile, the patient was treated with fluconazole (400 mg/day) for 6 months. Seven months later, the patient underwent second-stage surgery. The microbiological tests on the spacer were all negative. After 12 months of follow-up, the patient has fully recovered and no radiological signs of infection have been detected. Conclusions Given the exceptionality of this complication, it is important to report these events to better understand the clinical outcomes after the selected therapeutic options to prevent and forestall the development of either bacterial or fungal spacer infections. |
| first_indexed | 2024-12-24T05:31:07Z |
| format | Article |
| id | doaj.art-ea82717885f84502855f80a8151e3967 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-24T05:31:07Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-ea82717885f84502855f80a8151e39672022-12-21T17:13:11ZengBMCBMC Infectious Diseases1471-23342021-05-012111510.1186/s12879-021-06113-8A spacer infection by Candida albicans secondary to a Staphylococcus capitis prosthetic joint infection: a case reportMarta Bottagisio0Alessandro Bidossi1Nicola Logoluso2Antonio Pellegrini3Elena De Vecchi4IRCCS Istituto Ortopedico Galeazzi, Laboratory of Clinical Chemistry and MicrobiologyIRCCS Istituto Ortopedico Galeazzi, Laboratory of Clinical Chemistry and MicrobiologyIRCCS Istituto Ortopedico Galeazzi, Chirurgia Ricostruttiva e delle Infezioni osteo-articolari (C.R.I.O)IRCCS Istituto Ortopedico Galeazzi, Chirurgia Ricostruttiva e delle Infezioni osteo-articolari (C.R.I.O)IRCCS Istituto Ortopedico Galeazzi, Laboratory of Clinical Chemistry and MicrobiologyAbstract Background Prosthetic joint infection (PJI) is one of the most feared complications following total arthroplasty surgeries. Gram-positive bacteria are the most common microorganisms implicated in PJIs, while infections mediated by fungi only account for 1% of cases. When dealing with PJIs, a two-stage revision arthroplasty is widely used. Briefly, a spacer is introduced until re-implantation of the definitive prosthesis to provide skeleton stabilization while delivering antibiotics in the site of the infection. Sometimes, antimicrobial therapy may fail, but the isolation of a second microorganism from the spacer is uncommon and even less frequent that of a yeast. Case presentation Here is described a case of a 75-year-old woman who underwent two-stage revision surgery of the left hip prosthesis secondary to a Staphylococcus capitis infection, whose spacer was found to be infected by Candida albicans at a later time. Briefly, the patient underwent revision surgery of the hip prosthesis for a suspected PJI. After the debridement of the infected tissue, an antibiotic-loaded spacer was implanted. The microbiological analysis of the periprosthetic tissues and the implant depicted a S. capitis infection that was treated according to the antimicrobial susceptibility profile of the clinical isolate. Three months later, the patient was admitted to the emergency room due to local inflammatory signs. Synovial fluid was sent to the laboratory for culture. No evidence of S. capitis was detected, however, a yeast was identified as Candida albicans. Fifteen days later, the patient was hospitalized for the removal of the infected spacer. Microbiological cultures confirmed the results of the synovial fluid analysis. According to the susceptibility profile, the patient was treated with fluconazole (400 mg/day) for 6 months. Seven months later, the patient underwent second-stage surgery. The microbiological tests on the spacer were all negative. After 12 months of follow-up, the patient has fully recovered and no radiological signs of infection have been detected. Conclusions Given the exceptionality of this complication, it is important to report these events to better understand the clinical outcomes after the selected therapeutic options to prevent and forestall the development of either bacterial or fungal spacer infections.https://doi.org/10.1186/s12879-021-06113-8Case reportSpacer infectionCandida albicansStaphylococcus capitisTotal hip arthroplastyProsthetic joint infection |
| spellingShingle | Marta Bottagisio Alessandro Bidossi Nicola Logoluso Antonio Pellegrini Elena De Vecchi A spacer infection by Candida albicans secondary to a Staphylococcus capitis prosthetic joint infection: a case report BMC Infectious Diseases Case report Spacer infection Candida albicans Staphylococcus capitis Total hip arthroplasty Prosthetic joint infection |
| title | A spacer infection by Candida albicans secondary to a Staphylococcus capitis prosthetic joint infection: a case report |
| title_full | A spacer infection by Candida albicans secondary to a Staphylococcus capitis prosthetic joint infection: a case report |
| title_fullStr | A spacer infection by Candida albicans secondary to a Staphylococcus capitis prosthetic joint infection: a case report |
| title_full_unstemmed | A spacer infection by Candida albicans secondary to a Staphylococcus capitis prosthetic joint infection: a case report |
| title_short | A spacer infection by Candida albicans secondary to a Staphylococcus capitis prosthetic joint infection: a case report |
| title_sort | spacer infection by candida albicans secondary to a staphylococcus capitis prosthetic joint infection a case report |
| topic | Case report Spacer infection Candida albicans Staphylococcus capitis Total hip arthroplasty Prosthetic joint infection |
| url | https://doi.org/10.1186/s12879-021-06113-8 |
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