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This case report describes an 85-year-old female with a Candida albicans periprosthetic hip infection complicated by recurrent dislocations following revision total hip arthroplasty (THA). The patient presented with a draining sinus and underwent debridement and removal of the acetabular component after intraoperative cultures confirmed polymicrobial infection including C. albicans, followed by a course of trimethoprim-sulfamethoxazole and fluconazole, resulting in infection eradication and a well-healed wound at 12-month follow-up.
Early recognition and combined surgical-pharmacological management can lead to successful eradication of rare polymicrobial fungal PJIs in revision THA, even in the presence of recurrent instability.
Introduction: Fungal periprosthetic joint infections (PJI) are exceptionally rare, accounting for <1% of all PJIs. Among them, Candida albicans is the most frequently implicated pathogen, yet its management remains highly challenging. Case Report: We report the case of an 85-year-old female who presented with a draining sinus at the right hip, 4 weeks after revision total hip arthroplasty (THA). Her surgical history included a prior failed revision due to recurrent dislocation. Clinical and laboratory findings suggested PJI. Intraoperative cultures and sonication confirmed multimicrobial and C. albicans infection. Following 4 months of antimicrobial therapy, she underwent debridement and removal of the acetabular component. Postoperatively, she received a 4-week course of trimethoprim–sulfamethoxazole (960 mg 3 times daily) and a 12-week course of fluconazole (200 mg twice daily). The post-operative course was uneventful. At 6 and 12-month follow-up, she remained asymptomatic with a well-healed wound and negative inflammatory markers. Conclusion: Early recognition and combined surgical–pharmacological management can lead to infection eradication and functional preservation, even in rare polymicrobial fungal PJIs.
