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Deep Infection With Candida albicans Following Total Hip Replacement: Two Case Reports

Presman, Benjamin MD*; Christensen, Jens Jørgen MD, DMSc; Broeng, Leif MD*; Marckmann, Peter MD, DMSc; Nielsen, Xiaohui Chen MD, PhD

Infectious Diseases in Clinical Practice: July 2014 - Volume 22 - Issue 4 - p e72–e73
doi: 10.1097/IPC.0b013e3182a1eeae
Case Reports

Two cases of Candida albicans infections following total hip replacement are presented. The first case describes a patient with bilateral hip prosthesis and peritoneal dialysis. Revision surgery of the left hip, with exchange of a loosened acetabular cup, revealed C. albicans in 5 tissue specimens. This prosthetic infection was probably a result of hematogenous seeding from an infected peritoneal dialysis catheter. The second case describes a patient who had C. albicans superinfection after 2 surgical revisions on early deep infection following a primary total hip replacement. Direct inoculation of skin microflora at time of surgery is the most probable explanation. Both patients had predisposing factors as comorbidities and complicated prosthetic surgery. Treatment was a combination of revision surgery and antimicrobial therapy with fluconazole.

From the *Department of Orthopedic Surgery, Køge Hospital, Køge; †Department of Clinical Microbiology, Slagelse Hospital, Slagelse; and ‡Department of Internal Medicine, Section of Nephrology, Roskilde Hospital, Roskilde, Denmark.

Correspondence to: Xiaohui Chen Nielsen, MD, PhD, Department of Clinical Microbiology, Slagelse Hospital, Ingemannsvej 18, 4200 Slagelse, Denmark. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2014 by Lippincott Williams & Wilkins.