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Fungal Periprosthetic Hip Joint Infections

Introduction: Fungal hip prosthetic joint infections (PJIs) are rare but severe infections. Their incidence has increased in the last decades due to the aging population, as well as due to the increased number of immunosuppressed hosts. The present review of all published fungal PJIs in hip arthropl...

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Autores principales: Koutserimpas, Christos, Naoum, Symeon, Giovanoulis, Vasileios, Raptis, Konstantinos, Alpantaki, Kalliopi, Dretakis, Konstantinos, Vrioni, Georgia, Samonis, George
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9601120/
https://www.ncbi.nlm.nih.gov/pubmed/36292030
http://dx.doi.org/10.3390/diagnostics12102341
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author Koutserimpas, Christos
Naoum, Symeon
Giovanoulis, Vasileios
Raptis, Konstantinos
Alpantaki, Kalliopi
Dretakis, Konstantinos
Vrioni, Georgia
Samonis, George
author_facet Koutserimpas, Christos
Naoum, Symeon
Giovanoulis, Vasileios
Raptis, Konstantinos
Alpantaki, Kalliopi
Dretakis, Konstantinos
Vrioni, Georgia
Samonis, George
author_sort Koutserimpas, Christos
collection PubMed
description Introduction: Fungal hip prosthetic joint infections (PJIs) are rare but severe infections. Their incidence has increased in the last decades due to the aging population, as well as due to the increased number of immunosuppressed hosts. The present review of all published fungal PJIs in hip arthroplasties aims to present as much data as possible for both medical and surgical treatment options, so that the best applicable management may be concluded. Methods: A meticulous review of all published fungal hip PJIs was conducted. Information regarding demographics, causative fungus, antifungal treatment (AFT), surgical management as well as the infection outcome was recorded. Results: A total of 89 patients suffering fungal hip PJI were identified. The patients’ mean age was 66.9 years. The mean time from initial arthroplasty to onset of symptoms was 69.3 months, while 40.4% of the patients were immunocompromised. The most common imaging method indicating diagnosis was plain X-ray or CT scan (20.2%), while definite diagnosis had become possible through cultures in most cases (98.9%), and/or histology (44.9%). The most frequently isolated fungus was C. albicans (49.4%), followed by C. parapsilosis (18%) and C. glabrata (12.4%), while bacterial co-infection was present in 32 cases (36%). Two-stage revision arthroplasty (TSRA) was the most commonly performed procedure (52.8%), with mean time between the two stages = 7.9 months. Regarding antifungal treatment (AFT), fluconazole was the preferred agent (62.9%), followed by amphotericin B (36%), while the mean duration of AFT was 5.1 months. Outcome was successful in 68 cases (76.4%). Conclusions: Both diagnosis and management of fungal PJIs in patients having undergone total hip arthroplasty are quite demanding. A multidisciplinary approach is of utmost importance, since the combination of AFT and TSRA appears to be the proper treatment method.
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spelling pubmed-96011202022-10-27 Fungal Periprosthetic Hip Joint Infections Koutserimpas, Christos Naoum, Symeon Giovanoulis, Vasileios Raptis, Konstantinos Alpantaki, Kalliopi Dretakis, Konstantinos Vrioni, Georgia Samonis, George Diagnostics (Basel) Review Introduction: Fungal hip prosthetic joint infections (PJIs) are rare but severe infections. Their incidence has increased in the last decades due to the aging population, as well as due to the increased number of immunosuppressed hosts. The present review of all published fungal PJIs in hip arthroplasties aims to present as much data as possible for both medical and surgical treatment options, so that the best applicable management may be concluded. Methods: A meticulous review of all published fungal hip PJIs was conducted. Information regarding demographics, causative fungus, antifungal treatment (AFT), surgical management as well as the infection outcome was recorded. Results: A total of 89 patients suffering fungal hip PJI were identified. The patients’ mean age was 66.9 years. The mean time from initial arthroplasty to onset of symptoms was 69.3 months, while 40.4% of the patients were immunocompromised. The most common imaging method indicating diagnosis was plain X-ray or CT scan (20.2%), while definite diagnosis had become possible through cultures in most cases (98.9%), and/or histology (44.9%). The most frequently isolated fungus was C. albicans (49.4%), followed by C. parapsilosis (18%) and C. glabrata (12.4%), while bacterial co-infection was present in 32 cases (36%). Two-stage revision arthroplasty (TSRA) was the most commonly performed procedure (52.8%), with mean time between the two stages = 7.9 months. Regarding antifungal treatment (AFT), fluconazole was the preferred agent (62.9%), followed by amphotericin B (36%), while the mean duration of AFT was 5.1 months. Outcome was successful in 68 cases (76.4%). Conclusions: Both diagnosis and management of fungal PJIs in patients having undergone total hip arthroplasty are quite demanding. A multidisciplinary approach is of utmost importance, since the combination of AFT and TSRA appears to be the proper treatment method. MDPI 2022-09-27 /pmc/articles/PMC9601120/ /pubmed/36292030 http://dx.doi.org/10.3390/diagnostics12102341 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Koutserimpas, Christos
Naoum, Symeon
Giovanoulis, Vasileios
Raptis, Konstantinos
Alpantaki, Kalliopi
Dretakis, Konstantinos
Vrioni, Georgia
Samonis, George
Fungal Periprosthetic Hip Joint Infections
title Fungal Periprosthetic Hip Joint Infections
title_full Fungal Periprosthetic Hip Joint Infections
title_fullStr Fungal Periprosthetic Hip Joint Infections
title_full_unstemmed Fungal Periprosthetic Hip Joint Infections
title_short Fungal Periprosthetic Hip Joint Infections
title_sort fungal periprosthetic hip joint infections
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9601120/
https://www.ncbi.nlm.nih.gov/pubmed/36292030
http://dx.doi.org/10.3390/diagnostics12102341
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