METHODS: This paper reports a case involving a 62-year-old female patient of Korean ethnicity with a periprosthetic infection after knee arthroplasty who underwent joint debridement. A preoperative metagenomic next-generation sequencing of joint aspirate revealed Staphylococcus epidermidis. However, postsurgical tissue cultures confirmed the fungal infection. The patient received oral voriconazole and intra-articular injection of voriconazole for antifungal treatment. Since bacterial infection could not be ruled out, we also prescribed levofloxacin. No infection recurrence was observed after more than 22 months of follow-up. In the treatment of this patient, successful short-term follow-up was achieved, but long-term efficacy still cannot be determined.
CONCLUSIONS: In addition to the case study, we provide an analysis of the diagnosis and treatment of fungal infection after arthroplasty, especially the efficacy of debridement, antibiotics, and implant retention for a short-term outcome.
方法:本文报道一例62岁的朝鲜族女性患者膝关节置换术后假体周围感染,进行关节清创。联合抽吸物的术前宏基因组下一代测序显示表皮葡萄球菌。然而,术后组织培养证实真菌感染。患者接受口服伏立康唑和关节内注射伏立康唑用于抗真菌治疗。既然不能排除细菌感染,我们还开了左氧氟沙星.随访22个月以上无感染复发。在这个病人的治疗中,成功的短期随访,但长期疗效仍无法确定。
结论:除了案例研究之外,我们提供了关节置换术后真菌感染的诊断和治疗分析,尤其是清创的功效,抗生素,和植入物保留短期结果。