Abstract
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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Conflict of interest
Shmuel Shoham’s research is funded by Astellas, Pfizer and Merck. He has served on data review committee for Astellas. This manuscript was, in part, supported by a National Institute of Health K24, AI85118 Grant.
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Shah, N.B., Shoham, S. & Nayak, S. Cryptococcus neoformans Prosthetic Joint Infection: Case Report and Review of the Literature. Mycopathologia 179, 275–278 (2015). https://doi.org/10.1007/s11046-014-9847-0
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DOI: https://doi.org/10.1007/s11046-014-9847-0