Candida albicans infection of a prosthetic knee replacement: a report and review of the literature.
A woman with rheumatoid arthritis who underwent total knee arthroplasty is described. The implant became infected with Staphylococcus epidermidis and she received a prolonged course of postoperative antistaphylococcal antibiotics. Four months postoperatively she developed a calf ulcer that grew Pseudomonas aeruginosa and required further antibiotic therapy. One year later she presented with a painful, swollen knee with radiographic findings suggesting loosening of the prosthetic knee implant. Arthrocentesis cultures grew Candida albicans. She was treated with arthrodesis, amphotericin B, 5-fluorocytosine, and ketoconazole and remains free of infection 21 months after removal of the prosthesis. The clinical course of 6 other cases of Candida prosthetic joint infections is reviewed.
Koch
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Department of Internal Medicine, Northwestern University Medical School, Chicago, IL 60611.
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001174:Arthrodesis; D002177:Candidiasis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D007717:Knee / Q000000981:diagnostic imaging; D007720:Knee Prosthesis; D011183:Postoperative Complications; D011859:Radiography; D013203:Staphylococcal Infections / Q000209:etiology
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents