Acremonium Species Combined with Penicillium Species Infection in Hip Hemiarthroplasty: A Case Report and Literature Review

Wu, Chia‐Yi; Huang, Haichao; Wu, Po Kuei; Chen, Wei Ming; Lai, Mei Chu; Chung, Lien Hsiang

doi:10.5301/hipint.5000205

Cited by 3 publications

(1 citation statement)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Wu et al described, to the best of our knowledge, the first PJI involving Acremonium along with Penicillium . The patient in the study had their hardware removed and was placed on fluconazole for 12 months [ 10 ]. It was shown previously that the most effective agents for Acremonium based on the minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) were amphotericin B, itraconazole, and ketoconazole [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Acremonium (Sarocladium) periprosthetic joint infection: case report, literature review, and proposed antifungal regimen

et al. 2022

View full text Add to dashboard Cite

Background Fungal periprosthetic joint infections are rare. Acremonium osteoarticular infections are scarcely reported. Variable susceptibility to antifungal agents have been reported and optimal pharmacotherapy has yet to be established. Here we illustrate an Acremonium osteoarticular infection involving a prosthetic joint and present an antifungal regimen that had led to treatment success. Case presentation A 60-year-old female with a body mass index (BMI) of 40 had left total knee arthroplasty done in 2012 with a cementless implant for knee osteoarthritis. In 2019, the patient had asymptomatic, progressive osteolysis with fracture and migration of the femoral component warranting replacement. Eleven months later, the patient developed significant pain, redness, and swelling in the left leg and knee concerning for periprosthetic joint infection that failed outpatient antibiotic treatment. Further investigation revealed infection by Acremonium species. A revision of the joint was successfully completed, and the patient was placed on voriconazole for one year. Subsequent cultures did not yield any fungal growth. Conclusion While an optimal antifungal regimen for periprosthetic joint infections has not been well established, voriconazole is a relatively safe and effective agent that can be used as a long-term therapy. With variable susceptibility testing in reported isolates, individualized antifungal susceptibility should be used to guide therapy for Acremonium infections.

show abstract

Section: Discussionmentioning

confidence: 99%

Acremonium (Sarocladium) periprosthetic joint infection: case report, literature review, and proposed antifungal regimen

et al. 2022

View full text Add to dashboard Cite

show abstract

Non-Candida Fungal Prosthetic Joint Infections

et al. 2021

View full text Add to dashboard Cite

Background: Fungal prosthetic joint infections (PJIs) are rare, especially those caused by non-Candida species. Treatment has not been fully elucidated, since a plethora of antifungal and surgical interventions have been proposed. Τhis study represents an effort to clarify the optimal management of non-Candida fungal PJIs, by reviewing all relevant published cases. Methods: A thorough review of all existing non-Candida fungal PJIs in the literature was conducted. Data regarding demographics, responsible organisms, antifungal treatment (AFT), surgical intervention, time between initial arthroplasty and onset of symptoms, and time between onset of symptoms and firm diagnosis, as well as the infection’s outcome, were evaluated. Results: Forty-two PJIs, in patients with mean age of 66.2 years, were found and reviewed. Aspergillus spp. were isolated in most cases (10; 23.8%), followed by Coccidioides spp. (7; 16.7%) and Pichiaanomala (5; 11.9%). Fluconazole was the preferred antifungal regimen (20 cases; 47.6%), followed by amphotericin B (18 cases; 42.9%), while the mean AFT duration was 9.4 months (SD = 7.06). Two-stage revision arthroplasty (TSRA) was performed in 22 cases (52.4%), with the mean time between stages being 5.2 months (SD = 2.9). The mean time between initial joint implantation and onset of symptoms was 42.1 months (SD = 50.7), while the mean time between onset of symptoms and diagnosis was 5.8 months (SD = 14.3). Conclusions: Non-Candida fungal PJIs pose a clinical challenge, demanding a multidisciplinary approach. The present review has shown that combination of TSRA separated by a 3–6-month interval and prolonged AFT has been the standard of care in the studied cases.

show abstract

Mixed Fungal Biofilms: From Mycobiota to Devices, a New Challenge on Clinical Practice

et al. 2022

View full text Add to dashboard Cite

Most current protocols for the diagnosis of fungal infections are based on culture-dependent methods that allow the evaluation of fungal morphology and the identification of the etiologic agent of mycosis. Most current protocols for the diagnosis of fungal infections are based on culture-dependent methods that enable the examination of the fungi for further identification of the etiological agent of the mycosis. The isolation of fungi from pure cultures is typically recommended, as when more than one species is identified, the second agent is considered a contaminant. Fungi mostly survive in highly organized communities that provoke changes in phenotypic profile, increase resistance to antifungals and environmental stresses, and facilitate evasion from the immune system. Mixed fungal biofilms (MFB) harbor more than one fungal species, wherein exchange can occur that potentialize the effects of these virulence factors. However, little is known about MFB and their role in infectious processes, particularly in terms of how each species may synergistically contribute to the pathogenesis. Here, we review fungi present in MFB that are commensals of the human body, forming the mycobiota, and how their participation in MFB affects the maintenance of homeostasis. In addition, we discuss how MFB are formed on both biotic and abiotic surfaces, thus being a significant reservoir of microorganisms that have already been associated in infectious processes of high morbidity and mortality.

show abstract

Acremonium Species Combined with Penicillium Species Infection in Hip Hemiarthroplasty: A Case Report and Literature Review

Abstract: We reported a prosthetic hip infection due to Acremonium and Penicillium species. Removal of the prosthesis, antifungal therapy, and re-implantation after 4 months were successful.

Cited by 3 publications

References 10 publications

Acremonium (Sarocladium) periprosthetic joint infection: case report, literature review, and proposed antifungal regimen

Acremonium (Sarocladium) periprosthetic joint infection: case report, literature review, and proposed antifungal regimen

Non-Candida Fungal Prosthetic Joint Infections

Mixed Fungal Biofilms: From Mycobiota to Devices, a New Challenge on Clinical Practice

Contact Info

Product

Resources

About