Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Austria.
Mycoses. 2011 Oct;54 Suppl 3:22-7. doi: 10.1111/j.1439-0507.2011.02107.x.
Prosthetic joint infections (PJI) are rarely due to fungal agents and if so they are mainly caused by Candida strains. This case represents a PJI caused by a multi-drug resistant Pseudallescheria apiosperma, with poor in vivo response to itraconazole and voriconazole. This case differs also by the way of infection, since the joint infection did not follow a penetrating trauma. In the majority of cases, Scedosporium extremity infections remain local in immunocompetent individuals. We report a persistent joint infection with multiple therapeutic failures, and subsequent amputation of the left leg. Detailed clinical data, patient history, treatment regime and outcome of a very long-lasting (>4 years) P. apiosperma prosthetic knee infection in an immunocompetent, 61-year-old male patient are presented with this case. The patient was finally cured by the combination of multiple and extensive surgical interventions and prolonged antifungal combination therapy with voriconazole and terbinafine.
人工关节感染（PJI）很少由真菌引起，如果是真菌引起的，主要是由念珠菌属引起的。本病例代表了一例由多药耐药拟青霉属引起的 PJI，伊曲康唑和伏立康唑的体内反应不佳。该病例还因感染途径不同而有所不同，因为关节感染并没有发生穿透性创伤。在大多数情况下，在免疫功能正常的个体中，帚霉属的肢体感染仍为局部感染。我们报告了一例持续的关节感染，多次治疗失败，随后左腿截肢。本病例报告了一例非常持久（>4 年）的免疫功能正常的 61 岁男性患者的拟青霉属人工膝关节感染，详细介绍了患者的临床数据、病史、治疗方案和结果。该患者最终通过多次广泛的手术干预和伏立康唑与特比萘芬联合的长期抗真菌治疗治愈。
