title: Candida prosthetic infections: case series and literature review.
abstract: Candida prosthetic joint infections are considered to be rare. We retrospectively studied patients treated for Candida prosthetic infections between 1 January 1995 and 31 December 2007 in our infectious diseases department, a tertiary referral centre. We identified 7 patients, 4 with knee and 3 with hip prosthetic infections. The most frequent fungal agent was Candida albicans (4 cases), followed by Candida parapsilosis (2 cases) and Candida guillermondii (1 case). All the patients received antifungal treatment for a prolonged period. Five patients had their prosthesis removed and 3 had reimplantation, 1 patient was treated with debridement and prosthetic retention, and the last patient refused surgery. The mean follow-up time was 2.5 y. At the last evaluation, 3 patients were considered as cured, 3 patients presented a secondary bacterial infection leading to amputation for 2 of them, and 1 patient died from heart failure. During Candida prosthetic joint infections, the epidemiological characteristics and the location of the prosthesis are very similar to bacterial prosthetic infections. The benchmark antifungal therapies remain amphotericin B and/or fluconazole.
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpital Pellegrin, Université Victor Segalen Bordeaux 2, CHU de Bordeaux, Bordeaux, France. herve.dutronc@chu-bordeaux.fr
authors.forename: Herve
authors.initials: H
authors.lastname: Dutronc
authors.forename: Frédéric A
authors.initials: FA
authors.lastname: Dauchy
authors.forename: Charles
authors.initials: C
authors.lastname: Cazanave
authors.forename: Catherine
authors.initials: C
authors.lastname: Rougie
authors.forename: Sabine
authors.initials: S
authors.lastname: Lafarie-Castet
authors.forename: Bernard
authors.initials: B
authors.lastname: Couprie
authors.forename: Thierry
authors.initials: T
authors.lastname: Fabre
authors.forename: Michel
authors.initials: M
authors.lastname: Dupon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D001168:Arthritis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D002175:Candida / Q000145:classification / Q000302:isolation & purification*; D002177:Candidiasis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents