Candida infection in total knee arthroplasty with successful reimplantation.

Abstract

Fungal infections associated with prosthetic joints are uncommon. The first case report describes a woman with insidious onset of a candidal infection of a revision total knee arthroplasty. After multiple joint debridements and prolonged antibacterial and antifungal therapy, she had a successful reimplantation of a knee prosthesis. The second case report concerns a man who had a primary cemented total knee arthroplasty that became infected with Candida albicans. He underwent resection arthroplasty with eventual replant without recurrence at 20 years. Although resection arthroplasty should be maintained as the gold standard in the surgical treatment of this problem, the first case shows a successful short-term outcome ofreimplantation of a patient with fungal infection of long-stemmed, revision total knee replacement. It also shows a treatment failure with fluconazole that was cured by voriconazole and caspofungin, two more recently developed antifungal agents.