Cobo Fernando, Rodríguez-Granger Javier, Sampedro Antonio, Aliaga-Martínez Luis, Navarro-Marí José María
Department of Microbiology, Hospital Virgen de las Nieves, Granada, Spain.
Department of Internal Medicine, Hospital Virgen de las Nieves, Granada, Spain.
J Bone Jt Infect. 2017 Feb 5;2(2):114-121. doi: 10.7150/jbji.17699. eCollection 2017.
Fungal microorganisms are still a rare cause of bone and joint infections. We report a new case of knee prosthetic joint infection due to in a patient with a previous two-stage right knee arthroplasty for septic arthritis due to occurred several months ago. Moreover, the treatment in 76 cases of prosthetic joint infection has been discussed. Forty patients were female and mean age at diagnosis was 65.7 (± SD 18) yrs. No risk factors for candidal infection were found in 25 patients. Infection site was the knee in 38 patients and hip in 36; pain was present in 44 patients and swelling in 24. The most frequent species was , followed by . Eleven patients were only treated with antifungal drugs being the outcome favourable in all of them. Two-stage exchange arthroplasty was performed in 30 patients, and resection arthroplasty in other 30; in three patients one-stage exchange arthroplasty was done. A favourable outcome was found in 58 patients after antifungal plus surgical treatment, in 11 after antifungal treatment alone and in one after surgery alone. The type of treatment is still not clearly defined and an algorithm for treatment in fungal PJI should be established, but various types of surgical procedures may be applied.
真菌微生物仍然是骨与关节感染的罕见病因。我们报告了一例膝关节假体关节感染的新病例，该患者数月前因[此处原文有缺失信息]导致的化脓性关节炎接受了两阶段右膝关节置换术。此外，还讨论了76例[此处原文有缺失信息]假体关节感染的治疗情况。40例患者为女性，诊断时的平均年龄为65.7（±标准差18）岁。25例患者未发现念珠菌感染的危险因素。38例患者的感染部位为膝关节，36例为髋关节；44例患者有疼痛，24例有肿胀。最常见的菌种是[此处原文有缺失信息]，其次是[此处原文有缺失信息]。11例患者仅接受抗真菌药物治疗，所有患者预后良好。30例患者接受了两阶段置换关节成形术，另外30例接受了切除关节成形术；3例患者接受了一阶段置换关节成形术。抗真菌加手术治疗后，58例患者预后良好，11例仅接受抗真菌治疗的患者预后良好，1例仅接受手术治疗的患者预后良好。治疗类型仍未明确界定，应建立真菌性假体关节感染的治疗算法，但可应用多种手术方法。
