{"id":24566,"date":"2026-09-21T10:15:17","date_gmt":"2026-09-21T08:15:17","guid":{"rendered":"https:\/\/www.labpublishers.com\/ejmd\/?post_type=article&#038;p=24566"},"modified":"2026-09-22T10:16:12","modified_gmt":"2026-09-22T08:16:12","slug":"when-reimplantation-is-not-an-option-candida-glabrata-prosthetic-knee-infection-managed-with-rezafungin-and-staged-arthrodesis","status":"publish","type":"article","link":"https:\/\/www.labpublishers.com\/ejmd\/article\/when-reimplantation-is-not-an-option-candida-glabrata-prosthetic-knee-infection-managed-with-rezafungin-and-staged-arthrodesis\/","title":{"rendered":"WHEN REIMPLANTATION IS NOT AN OPTION: CANDIDA GLABRATA PROSTHETIC KNEE INFECTION MANAGED WITH REZAFUNGIN AND STAGED ARTHRODESIS"},"content":{"rendered":"<p style=\"text-align: justify;\">Fungal prosthetic joint infections are rare but challenging complications of total knee arthroplasty, particularly when caused by\u00a0<em>Candida glabrata<\/em>, a species associated with reduced azole susceptibility. We report a case of chronic\u00a0<em>C. glabrata<\/em>\u00a0prosthetic knee infection following right total knee arthroplasty, complicated by extensive soft-tissue loss and extensor mechanism failure. Microbiological testing demonstrated low echinocandin minimum inhibitory concentrations and intermediate susceptibility to fluconazole. Management prioritized definitive source control through serial surgical debridements and staged fixation, including temporary external fixation and eventual compression knee arthrodesis using crossed cannulated screws. Antifungal therapy was echinocandin-based and included two cycles of once-weekly rezafungin to maintain continuous antifungal coverage across staged procedures, followed by oral voriconazole. The patient also required culture-directed antibacterial therapy for recurrent polymicrobial coinfections, which was discontinued after definitive hardware removal. At the last follow-up, inflammatory markers had normalized, the surgical wound was healed, and radiographic imaging confirmed solid fusion without ongoing antimicrobial therapy. This case highlights the importance of definitive source control in hostile knees and suggests that long-acting echinocandins may facilitate prolonged, guideline-concordant antifungal therapy during complex, staged management of\u00a0<em>Candida glabrata<\/em>\u00a0prosthetic joint infection.<\/p>\n","protected":false},"template":"","meta":{"_acf_changed":false,"_members_access_role":[],"_members_access_error":""},"categories":[3151],"tags":[3168,1188,3167,3166,3169],"affiliation":[],"contributor":[3197,3196,3199,3198,3200],"journalissue":[3201],"class_list":["post-24566","article","type-article","status-publish","hentry","category-ejmd-vol-15-n-2-may-aug-2026","tag-candida-glabrata","tag-knee","tag-knee-arthroplasty","tag-prosthetic-joint-infection","tag-tissue-loss","contributor-f-morlini","contributor-f-pezone","contributor-g-placella","contributor-m-alessio-mazzola","contributor-v-salini","journalissue-ejmd-2026-vol-152-may-aug"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.7 - 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