title: [Prosthetic joint infection by Candida spp.].
abstract: BACKGROUND
  Fungal periprosthetic infectionis a rare entity. The aim of this report was to review our experience in two different educational hospitals.
  
  
  METHODS
  patients with documented prosthetic joint infection due to Candida spp. from February 2002 to October 2010 were retrospectively reviewed. Demographics, microbiological data, treatment and outcome of each patient was recorded.
  
  
  RESULTS
  Ten patients, 8 women and 2 men, with a meanage of 77.7 (range 66-92) years were identified. Nine patients had previous bacterial infection, received antibiotic treatment for more than 15 days and required multiple surgeries. The most frequent species was C. albicans with 6 cases. All patients received fluconazole and surgical treatment consisted of debridement without removing the implant in 3 cases and 2-stage exchange with a spacer in 7. The first surgical and antifungal approach failed in all cases and a second debridement was necessary in one case, a resection arthroplasty in 8 and chronic suppressive treatment with fluconazol in one. After a mean follow-up of 31 (range 2-67) months, two patients were free of infection.
  
  
  CONCLUSIONS
  Prosthetic joint infection was associated with long-term antibiotic treatment and multiples previous surgeries. Treatment with fluconazol and debridement or two stage replacement with a spacer was associated with a high failure rate.
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología. Hospital Clínic de Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: García-Oltra
authors.forename: S
authors.initials: S
authors.lastname: García-Ramiro
authors.forename: J C
authors.initials: JC
authors.lastname: Martínez
authors.forename: R
authors.initials: R
authors.lastname: Tibau
authors.forename: G
authors.initials: G
authors.lastname: Bori
authors.forename: J
authors.initials: J
authors.lastname: Bosch
authors.forename: J
authors.initials: J
authors.lastname: Mensa
authors.forename: A
authors.initials: A
authors.lastname: Soriano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use*; D019643:Arthroplasty, Replacement; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D003646:Debridement; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D008297:Male; D016459:Prosthesis-Related Infections / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D012086:Reoperation; D017211:Treatment Failure
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole