التفاصيل البيبلوغرافية
| العنوان: |
Prosthetic joint infection in an immunocompetent patient caused by Lomentospora prolificans. |
| المؤلفون: |
Yoonjung Lee, Minji Kim, Sarah Kim, Tae-Hoon Oh, Seong Eun Kim, Uh Jin Kim, Seung-Ji Kang, Sook-In Jung, Kyung-Hwa Park |
| المصدر: |
Infection & Chemotherapy; 2022 Supplement, Vol. 54, pS376-S377, 2p |
| مصطلحات موضوعية: |
JOINT infections, ARTIFICIAL joints, KNEE joint, ANTIFUNGAL agents, TERBINAFINE, CASPOFUNGIN |
| مستخلص: |
Lomentospora prolificans is increasingly recognized as the cause of serious infections in the im- munocompromised host, and also known to cause local infections in immunocompetent host. Treatment of L. prolificans infection is challenging because of pan-drug resistant of this organism. Here, we report a rare case of L. prolificans prosthetic knee joint infection. A 51-year-old male with history of total right knee arthroplasty one year ago visited our hospital with right knee pain. His radiographic study showed periprosthetic loosening and increased joint effusion (Fig. 1). Scedosporium species were cultured in joint fluid aspiration. Using matrix-assisted laser desorption ionization-time-of-flight mass spectrometer, this strain was identified as L. prolificans. In vitro susceptibility testing using broth micro- dilution showed minimum inhibitory concentration as follows- voriconazole (8㎍/mL), amphotericin B, posaconazole (>8㎍/mL), itraconazole, caspofungin (>16㎍/mL). Right knee prosthesis was removed and joint spacer were inserted. L. prolificans were cultured in infected tissue and removed prosthesis. Combination antifungal therapy (voriconazole and terbinafine) were administrated. However, after two months, he revisited for worsened right knee swelling and skin color change around knee (Fig. 2). Open debridement and joint spacer change were performed. In debrided tissue, L. prolificans was cultured again. Voriconazole and terbinafine were continued, but no clinical improvement was achieved. Antifungal agents were changed to voriconazole and caspofungin 1 month after second surgery. After two weeks of antifungal change, his symptom and C-reactive protein level improved. Antifungal agents were changed to oral voriconazole and terbinafine. The patient is now clinically stable for 3 months. This case highlights the need for multiple surgical intervention and antifungal combination therapy for the treatment of pan-drug resistant L. prolificans infection. [ABSTRACT FROM AUTHOR] |
|
Copyright of Infection & Chemotherapy is the property of Korean Society of Infectious Diseases & Korean Society for Chemotherapy and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder