Journal
MYCOPATHOLOGIA
Volume 179, Issue 3-4, Pages 275-278Publisher
SPRINGER
DOI: 10.1007/s11046-014-9847-0
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Funding
- Astellas
- Pfizer
- Merck
- National Institute of Health [AI85118]
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [K24AI085118] Funding Source: NIH RePORTER
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A 77-year-old woman with diabetes mellitus, myasthenia gravis and bilateral total hip arthroplasties underwent a two-stage procedure followed by treatment with vancomycin for a coagulase-negative staphylococcal prosthetic hip infection. This was complicated by a spontaneous left hip dislocation with a hematoma that was evacuated; all intraoperative cultures grew out Cryptococcus neoformans. Treatment with intravenous liposomal amphotericin B was started. Her prosthetic device was retained, and she was treated for 12 weeks, after which she was transitioned to fluconazole for long-term therapy. The hip remained stable 1 year out from her admission, and she retained mobility with the assistance of a walker. Fungi are an uncommon but potentially devastating cause of prosthetic joint infections, and most are due to Candida species [1]. Cryptococcus neoformans is an ubiquitous yeast with worldwide distribution that generally causes infections in patients with major T cell immune deficiencies (e.g., HIV, transplantation and receipt of corticosteroids). Cryptococcal infections of native osteoarticular structures are uncommon, but have been well described in the literature [2, 3]. Data regarding cryptococcal prosthetic joint infections, however, are sparse [4].
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