Candida albicans prosthetic hip infection in elderly patients: Is fluconazole monotherapy an option?

Abstract

The increasing numbers of joint arthroplasties being undertaken, and the increase in patients with systemic illnesses undergoing the procedure, have contributed to a continuing increase in prosthetic joint infections. Candida prosthetic joint infection is a rare clinical entity, and only 12 cases of Candida albicans prosthetic hip infection have been described. Although surgery combined with a long period of antifungal medication is the usual treatment for fungal prosthetic joint infections, monotherapy with antifungal agents has only very rarely been used as a therapeutic option, especially in debilitated and elderly patients. We report herein the second case, to our knowledge, of C. albicans prosthetic hip arthritis successfully treated with fluconazole monotherapy and review the literature on the pathogenesis, clinical manifestations and management of these infections. Further studies on the use of fluconazole in the management of fungal prosthetic infections are needed.