First Reported Case of Periprosthetic Fungal Knee Joint Infection Caused by Candida viswanathii: A Case Report
- 1Department of Orthopaedics, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India.
- 2Department of Orthopaedics, KEM Hospital, Pune, Maharashtra, India.
- 3Department of Infectious Diseases, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India.
Abstract
Introduction: Periprosthetic joint infection (PJI) is a serious and potentially devastating complication of total knee arthroplasty (TKA). While bacterial pathogens account for the majority of cases, fungal PJI is exceedingly rare, representing <1% of all prosthetic joint infections. Among fungal organisms, Candida albicans is the most commonly implicated species. Candida viswanathii is an extremely rare fungal pathogen, and to the best of our knowledge, there are no previously reported cases of periprosthetic knee joint infection caused by this organism. We report the first such case, highlighting its clinical presentation, diagnostic challenges, and management. Case Report: We report the case of an 80-year-old non-immunocompromised male who developed a periprosthetic fungal knee joint infection following TKA. The clinical presentation was atypical, causing significant soft-tissue destruction with rupture of the arthrotomy and dislocation of the patella. After negative bacterial cultures and failed debridement procedures, repeat joint aspiration at our institute revealed C. viswanathii, confirmed using matrix-assisted laser desorption ionization–time-of-flight mass spectrometry. The patient subsequently underwent staged revision surgery with placement of amphotericin B–impregnated cement spacers and received prolonged systemic antifungal therapy. Due to extensive soft-tissue destruction and persistent intramedullary infection, knee arthrodesis using a novel cement rod (K-nail) static spacer technique was performed. Clinical and laboratory improvement was observed on follow-up. Conclusion: To our knowledge, this is the first reported case of periprosthetic knee joint infection caused by Candida viswanathii, a rare non-albicans Candida species, presenting with significant soft-tissue destruction and an atypical clinical course. Early suspicion, advanced microbiological identification, aggressive surgical management, and prolonged targeted antifungal therapy are critical for achieving successful outcomes.
Related
- Fungal Periprosthetic Joint Infection: A Systematic Review and Meta-analysis of Treatment Approaches and Clinical Outcomes.
- Periprosthetic Joint Infection Caused by Streptococcus equi Subspecies zooepidemicus: The First Reported Case Confirmed by Synovial Fluid Culture.
- Candida albicans Urinary Tract Infection with Suspected Fungal Hepatobiliary Disease in an Immunosuppressed Dog: A Case Report.
- Reported outcomes for patients following postoperative periprosthetic femoral fractures : a systematic review
- Culture-Specific Outcomes of Intra-Articular Antibiotic Infusion With Implant-Retaining Debridement for Periprosthetic Joint Infection After Unicompartmental Knee Arthroplasty
BibTeX
@article{joshi2026first,
title = {{First Reported Case of Periprosthetic Fungal Knee Joint Infection Caused by Candida viswanathii: A Case Report}},
author = {Satyajeet Joshi and Suresh Patil and Mahesh Kulkarni and Megh Shaligram and Shivaram Muthiah and Rasika Joshi},
journal = {Journal of Orthopaedic Case Reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8400},
url = {https://doi.org/10.13107/jocr.2026.v16.i11.8400},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - First Reported Case of Periprosthetic Fungal Knee Joint Infection Caused by Candida viswanathii: A Case Report
AU - Satyajeet Joshi
AU - Suresh Patil
AU - Mahesh Kulkarni
AU - Megh Shaligram
AU - Shivaram Muthiah
AU - Rasika Joshi
PY - 2026
DA - 2026/11/01
JO - Journal of Orthopaedic Case Reports
DO - 10.13107/jocr.2026.v16.i11.8400
UR - https://doi.org/10.13107/jocr.2026.v16.i11.8400
AB - Introduction: Periprosthetic joint infection (PJI) is a serious and potentially devastating complication of total knee arthroplasty (TKA). While bacterial pathogens account for the majority of cases, fungal PJI is exceedingly rare, representing <1% of all prosthetic joint infections. Among fungal organisms, Candida albicans is the most commonly implicated species. Candida viswanathii is an extremely rare fungal pathogen, and to the best of our knowledge, there are no previously reported cases of periprosthetic knee joint infection caused by this organism. We report the first such case, highlighting its clinical presentation, diagnostic challenges, and management. Case Report: We report the case of an 80-year-old non-immunocompromised male who developed a periprosthetic fungal knee joint infection following TKA. The clinical presentation was atypical, causing significant soft-tissue destruction with rupture of the arthrotomy and dislocation of the patella. After negative bacterial cultures and failed debridement procedures, repeat joint aspiration at our institute revealed C. viswanathii, confirmed using matrix-assisted laser desorption ionization–time-of-flight mass spectrometry. The patient subsequently underwent staged revision surgery with placement of amphotericin B–impregnated cement spacers and received prolonged systemic antifungal therapy. Due to extensive soft-tissue destruction and persistent intramedullary infection, knee arthrodesis using a novel cement rod (K-nail) static spacer technique was performed. Clinical and laboratory improvement was observed on follow-up. Conclusion: To our knowledge, this is the first reported case of periprosthetic knee joint infection caused by Candida viswanathii, a rare non-albicans Candida species, presenting with significant soft-tissue destruction and an atypical clinical course. Early suspicion, advanced microbiological identification, aggressive surgical management, and prolonged targeted antifungal therapy are critical for achieving successful outcomes.
SN - 2250-0685
SN - 2321-3817
ER -