Candida Auris Total Knee Arthroplasty Infection in an Immunocompetent Individual: Case Report and Literature Review.

Abstract

Introduction: Candida auris (C auris), a multidrug-resistant fungus, was declared by the Centers for Disease Control and Prevention as a serious global health threat in 2016. It is hard to identify, resistant to standard antifungal treatments, and spreads within health care settings, resulting in high morbidity and mortality in critically ill patients.

Case presentation: We report the case of a 60-year-old immunocompetent male with a protracted course of prosthetic knee joint infections. He received medical care at several health care facilities across 2 Midwestern states culminating in wound dehiscence and C auris infection necessitating prolonged antimicrobial treatment.

Discussion: C auris has been a pathogen of increasing nosocomial transmission with particular concern for multidrug resistance. Treatment is with prompt irrigation and debridement and polyethylene exchange and systemic antifungal treatment. Local treatment with antimicrobial impregnated cement can be used to reduce treatment duration and mitigate resistance.

Conclusions: With emerging concerns and the prevalence of infection with C auris, there should be greater vigilance in evaluating patients with repeat surgeries and health care contacts for fungal infection.