Single-Stage Revision With Fluconazole Monotherapy in Fungal Prosthetic Knee Joint Infections

• Main Authors: James C. George, D Ortho, MS (Orthopaedics), Jishar Sainulabdeen, MS (Orthopaedics), Samuel Chittaranjan, MS (Orthopaedics), FRCS (Trauma and Orthopaedics), Koshy George, MS (Orthopaedics), Subin Babu, MS (Orthopaedics)
• Format: Article
• Language: English
• Published: Elsevier 2021-02-01
• Series: Arthroplasty Today
• Subjects: Fungal PJI; Single stage revision; Antifungal therapy
• Online Access: http://www.sciencedirect.com/science/article/pii/S2352344120302521
• ISSN: 2352-3441

Fungal prosthetic joint infection is rare, and two-stage revision is usually advocated. We present our experience with 2 cases of fungal prosthetic knee joint infection presenting 25 months and 3 years after index surgery. Both patients were managed with single-stage revision arthroplasty and fluconazole monotherapy. They remain asymptomatic with good knee society score after 2 years of follow-up. Preoperative workup of all aseptic loosening cases should include extended culture for fungal elements. Single-stage revision with antifungal therapy for 3 months gives good results in nonimmunocompromised patients with good soft-tissue envelope.