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Peer-reviewedCC BYOpen forum infectious diseases

Fungal Periprosthetic Joint Infection: A Systematic Review and Meta-analysis of Treatment Approaches and Clinical Outcomes.

  • Farzad Pourghazi1
  • Seyed Mohammad Amin Alavi2
  • Takahiro Matsuo3
  • Georges Baaklini4
  • Matthew P Abdel5
  • Aaron J Tande1
  • Elie F Berbari1
5 affiliations
  1. 1Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA.
  2. 2Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
  3. 3Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  4. 4Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
  5. 5Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
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Abstract

Fungal periprosthetic joint infection (PJI) is a rare but serious complication of joint arthroplasty, with variable management and poorly defined outcomes. We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines, searching Ovid MEDLINE, Embase, Scopus, and Ovid Cochrane Central. Cohort studies were included in the quantitative synthesis, while case reports and series were reviewed qualitatively. Outcomes were treatment success, failure, reinfection, and mortality. We included 160 studies: 42 cohort studies and 118 case reports or case series, with 1025 fungal PJI cases. Pooled rates were 66.5% for treatment success, 36.5% for failure, 16.6% for reinfection, and 9.6% for mortality. Success and failure were extracted independently using study-specific definitions and are not necessarily complementary. Treatment-strategy estimates were descriptive; studies reporting DAIR had lower pooled success, but findings should be interpreted cautiously because of differences in patient selection, study design, and outcome definitions. These findings cannot establish comparative effectiveness.

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Cite

BibTeXRIS
BibTeX
@article{pourghazi2026fungal,
  title = {{Fungal Periprosthetic Joint Infection: A Systematic Review and Meta-analysis of Treatment Approaches and Clinical Outcomes.}},
  author = {Farzad Pourghazi and Seyed Mohammad Amin Alavi and Takahiro Matsuo and Georges Baaklini and Matthew P Abdel and Aaron J Tande and Elie F Berbari},
  journal = {Open forum infectious diseases},
  year = {2026},
  month = oct,
  doi = {10.1093/ofid/ofag657},
  url = {https://europepmc.org/article/MED/42898829},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Fungal Periprosthetic Joint Infection: A Systematic Review and Meta-analysis of Treatment Approaches and Clinical Outcomes.
AU  - Farzad Pourghazi
AU  - Seyed Mohammad Amin Alavi
AU  - Takahiro Matsuo
AU  - Georges Baaklini
AU  - Matthew P Abdel
AU  - Aaron J Tande
AU  - Elie F Berbari
PY  - 2026
DA  - 2026/10/08
JO  - Open forum infectious diseases
DO  - 10.1093/ofid/ofag657
UR  - https://europepmc.org/article/MED/42898829
AB  - Fungal periprosthetic joint infection (PJI) is a rare but serious complication of joint arthroplasty, with variable management and poorly defined outcomes. We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines, searching Ovid MEDLINE, Embase, Scopus, and Ovid Cochrane Central. Cohort studies were included in the quantitative synthesis, while case reports and series were reviewed qualitatively. Outcomes were treatment success, failure, reinfection, and mortality. We included 160 studies: 42 cohort studies and 118 case reports or case series, with 1025 fungal PJI cases. Pooled rates were 66.5% for treatment success, 36.5% for failure, 16.6% for reinfection, and 9.6% for mortality. Success and failure were extracted independently using study-specific definitions and are not necessarily complementary. Treatment-strategy estimates were descriptive; studies reporting DAIR had lower pooled success, but findings should be interpreted cautiously because of differences in patient selection, study design, and outcome definitions. These findings cannot establish comparative effectiveness.
SN  - 2328-8957
ER  -