Abstract
Pseudotumors associated with total hip arthroplasty have been associated with metal-on-metal and metal-on-polyethylene total hip arthroplasties due to a granulomatous foreign-body reaction to methyl methacrylate, polyethylene, or metal ion release, but they have not been related to prosthetic joint infections. In this paper, we report an unusual case of Candida albicans total hip arthroplasty infection, causing a large inflammatory pseudotumor of the hip joint. Fungal periprosthetic joint infections are a rare clinical entity and difficult to diagnose, and a pseudotumor may be part of their clinical presentation. They should be suspected in immunodeficient host patients when clinical symptoms of prosthetic joint infections are observed.
Highlights
Despite surgical advances and antibiotics evolution, periprosthetic infections still represent a challenge for orthopaedic surgeons because of the demanding surgical treatment and unpredictable clinical results.The most common pathogens involved in prosthetic joint infections are gram-positive Staphylococcal species bacteria followed by aerobic gram-negative Bacilli and Anaerobes species [1]
We report an unusual case of Candida albicans total hip arthroplasty infection, causing a large inflammatory pseudotumor of the hip joint
We report an atypical case of Candida albicans total hip arthroplasty infection, causing an inflammatory pseudotumor of the hip joint
Summary
Despite surgical advances and antibiotics evolution, periprosthetic infections still represent a challenge for orthopaedic surgeons because of the demanding surgical treatment and unpredictable clinical results. We report an atypical case of Candida albicans total hip arthroplasty infection, causing an inflammatory pseudotumor of the hip joint. To our knowledge, this is the first case reported in the literature in which such kind of clinical finding was identified in periprosthetic fungal infection of the joints. In 2010, a 70-year-old Caucasian woman was referred by an infectious disease specialist to the Bone and Joint Infection Unit of our Orthopaedic Department because of a Candida albicans periprosthetic infection of the left hip joint. The patient was immunocompromised due to immuno-suppressive therapy with steroids and methotrexate, taken for rheumatoid arthritis and Sjogren’s syndrome Her orthopaedic history consisted of a total hip arthroplasty in 2004 and a subsequent early revision for prosthetic instability in the same year. At the last followup, the patient presented with a pain-free hip joint and a swelling of the greater
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