First Reported Case of Periprosthetic Fungal Knee Joint Infection Caused by Candida viswanathii: A Case Report
Year: 2026
Type: article
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.
Institution: Deenanath Mangeshkar Hospital and Research Center
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $250
OpenAlex ID: W7225589530