, Volume 183, Issue 3, pp 579–584 | Cite as

Staged Reimplantation of a Total Hip Prosthesis After Co-infection with Candida tropicalis and Staphylococcus haemolyticus: A Case Report

  • Sujeesh Sebastian
  • Rajesh Malhotra
  • Ashish Pande
  • Deepak Gautam
  • Immaculata Xess
  • Benu Dhawan
Short Communication


Fungal prosthetic joint infection is a rare complication in total joint arthroplasty. There are no established guidelines for management of these infections. We present a case of a 53-year-old male with a hip joint prosthesis co-infected with Candida tropicalis and Staphylococcus haemolyticus. A two-stage exchange arthroplasty was performed. The patient underwent implant removal, debridement, irrigation with saline solution and application of cement spacer impregnated with vancomycin followed by aggressive antimicrobial treatment in first stage. Complete eradication of infection was demonstrated by negative culture of sonicated cement spacer fluid and negative 16S rRNA and 18S rRNA gene PCR of sonicate fluid, synovial fluid and periprosthetic tissue samples. He underwent second-stage revision hip arthroplasty after 9 months of the first stage. At the latest follow-up, there was no evidence of recurrence of infection. This case illustrates the utility of sonication of biomaterials and molecular techniques for microbiological confirmation of absence of infection in staged surgeries which is required for a successful outcome.


Antibiotic-impregnated cement spacers Prosthetic joint infection Sonication of biomaterials 


Compliance with Ethical Standards

Conflict of interest

The authors declared that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Sujeesh Sebastian
    • 1
  • Rajesh Malhotra
    • 2
  • Ashish Pande
    • 2
  • Deepak Gautam
    • 2
  • Immaculata Xess
    • 1
  • Benu Dhawan
    • 1
  1. 1.Department of MicrobiologyAll India Institute of Medical SciencesNew DelhiIndia
  2. 2.Department of OrthopaedicsAll India Institute of Medical SciencesNew DelhiIndia

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