Two-Stage Revision Total Knee Arthroplasty for Chronic Histoplasma Capsulatum Prosthetic Joint Infection: A Case Report. Issue 3 (8th July 2022)

• Record Type: Journal Article
• Authors: Williams, Brady T.; Hogan, Craig; Damioli, Laura
• Is Part Of: JBJS case connector. Volume 12:Issue 3(2022)
• Publication Date: 2022-07-08
• Subjects: PJI -- TKA -- fungal -- histoplasma; Orthopedic surgery -- Case studies -- Periodicals; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic Procedures; Orthopedic surgery; Periodicals; Electronic journals; Case studies; Periodicals; 616.7
• DOI: 10.2106/JBJS.CC.22.00155
• Languages: English
• ISSNs: 2160-3251

Abstract

Abstract : Case: This report describes a histoplasma capsulatum total knee prosthetic joint infection (PJI) in an immunosuppressed patient treated with a 2-stage revision. The diagnosis of PJI was made based on minor criteria, and the causative organism was identified from cultures obtained at the time of explantation. The patient underwent induction with amphotericin B, followed by oral antifungal therapy and a successful 2-stage revision with a hinged prosthesis with an interval of ∼7 months between stage 1 and stage 2. At the most recent follow-up (18 months), she remained clear from infection with planned lifetime antifungal suppression Conclusion: This case report highlights the importance of consideration of atypical organisms when treating immunocompromised patients. Furthermore, this case report documents one of the few cases of histoplasma PJI and provides a successful treatment algorithm to potentially be applied to future cases.