TY - JOUR
T1 - Cryptococcus neoformans Prosthetic Joint Infection
T2 - Case Report and Review of the Literature
AU - Shah, Neel B.
AU - Shoham, Shmuel
AU - Nayak, Seema
N1 - Funding Information:
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.
Publisher Copyright:
© 2014, Springer Science+Business Media Dordrecht.
PY - 2015/4
Y1 - 2015/4
N2 - 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].
AB - 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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U2 - 10.1007/s11046-014-9847-0
DO - 10.1007/s11046-014-9847-0
M3 - Article
C2 - 25524725
AN - SCOPUS:84925533752
SN - 0301-486X
VL - 179
SP - 275
EP - 278
JO - Mycopathologia
JF - Mycopathologia
IS - 3-4
ER -