title: Acremonium species combined with Penicillium species infection in hip hemiarthroplasty: a case report and literature review.
abstract: OBJECTIVE
  To illustrate that Acremonium and Penicillium species are being increasingly recognised in periprosthetic joint infections (PJIs).
  
  
  METHODS
  A 47-year-old male with liver cirrhosis and bilateral hip hemiarthroplasties complained of persistent right hip pain. Bone scan was suspicious for right hip septic arthritis. Laboratory studies revealed an elevated erythrocyte sedimentation rate (ESR; 127 mm/h) and C-reactive protein (CRP; 16.171 mg/L). At surgery caseous necrosis with a yellowish appearance around the hip was noted. Intraoperative cultures were positive for Acremonium and Penicillium species 2 weeks after inoculation. After 4 months of fluconazole monotherapy a successful revision right total hip arthroplasty was performed, the patient is walking without assistance at 1 year after surgery.
  
  
  CONCLUSIONS
  We reported a prosthetic hip infection due to Acremonium and Penicillium species. Removal of the prosthesis, antifungal therapy, and re-implantation after 4 months were successful.
authors.affiliation: 1 Division of Orthopaedic Oncology, Orthopaedic Department, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City - Taiwan.
authors.forename: Cheng-Yi
authors.initials: CY
authors.lastname: Wu
authors.forename: Hui-Kuang
authors.initials: HK
authors.lastname: Huang
authors.forename: Po-Kuei
authors.initials: PK
authors.lastname: Wu
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Chen
authors.forename: Mei-Chu
authors.initials: MC
authors.lastname: Lai
authors.forename: Lien-Hsiang
authors.initials: LH
authors.lastname: Chung
mesh_terms: D000164:Acremonium; D062785:Hemiarthroplasty; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D010407:Penicillium; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy