Wada M, Baba H, Imura S
Department of Orthopaedic Surgery, Fukui Medical School, Shimoaizuki, Japan.
J Arthroplasty. 1998 Jun;13(4):479-82. doi: 10.1016/s0883-5403(98)90019-5.
We report a 77-year-old man who developed Candida parapsilosis infection following total knee arthroplasty. Knee joint effusion was noted 2 weeks after surgery, and repeated cultures of aspirated fluid established the diagnosis of Candida parapsilosis infection 4 weeks after surgery. Treatment consisted of debridement and lavage of the involved joint together with continuous irrigation with fluconazole for 4 weeks, followed by oral fluconazole for another 6 months. At 3 years follow-up, the patient was doing well and radiological examination of the affected knee showed a firm attachment of the prosthesis. We suggest that early identification of the causative organism followed by continuous irrigation and use of appropriate antifungal medication may prevent joint instability and spares the removal of the prosthesis.
我们报告了一名77岁男性,他在全膝关节置换术后发生了近平滑念珠菌感染。术后2周发现膝关节积液,对抽吸液进行反复培养后在术后4周确诊为近平滑念珠菌感染。治疗包括对受累关节进行清创和灌洗,同时用氟康唑持续冲洗4周,随后口服氟康唑再持续6个月。在3年的随访中,患者情况良好,对患膝的放射学检查显示假体固定牢固。我们建议早期识别病原体,随后持续冲洗并使用适当的抗真菌药物,这可能会预防关节不稳并避免假体移除。