title: Blastomycosis infection of the knee treated with staged total knee arthroplasty.
abstract: Blastomycosis is a rare fungal disease that can cause intraarticular infection and joint destruction requiring surgical reconstruction. We describe a patient who presented with destruction of the knee joint of unknown etiology. The patient was initially treated with debridement and spacer placement followed by antifungal therapy after cultures grew blastomycosis. Following adequate treatment of the infection, the patient was taken back to the operating room for reconstruction with a total knee arthroplasty. The patient had a successful outcome with no evidence of infection at two years following surgery. To our knowledge, this case report represents the first documented case in which a blastomycotic infection of a native knee was successfully treated with a two-stage total knee arthroplasty.
authors.affiliation: University of Virginia School of Medicine, Charlottesville, VA, United States.
authors.forename: Ian S
authors.initials: IS
authors.lastname: MacLean
authors.affiliation: Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, VA, United States.
authors.forename: Shandra R
authors.initials: SR
authors.lastname: Day
authors.affiliation: Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, VA, United States.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Moore
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, United States. Electronic address: jamesbrowne@virginia.edu.
authors.forename: James A
authors.initials: JA
authors.lastname: Browne
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001759:Blastomycosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D003646:Debridement / Q000379:methods*; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000628:therapy*
chemical_list: D000935:Antifungal Agents
keywords: Blastomycosis; Infection; Osteomyelitis; Total knee arthroplasty