{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:19:33Z","timestamp":1790713173532,"version":"4.1.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["RC Project"],"award-info":[{"award-number":["RC Project"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Prosthetic joint infection (PJI) is one of the most feared complications following total arthroplasty surgeries. Gram-positive bacteria are the most common microorganisms implicated in PJIs, while infections mediated by fungi only account for 1% of cases. When dealing with PJIs, a two-stage revision arthroplasty is widely used. Briefly, a spacer is introduced until re-implantation of the definitive prosthesis to provide skeleton stabilization while delivering antibiotics in the site of the infection. Sometimes, antimicrobial therapy may fail, but the isolation of a second microorganism from the spacer is uncommon and even less frequent that of a yeast.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>Here is described a case of a 75-year-old woman who underwent two-stage revision surgery of the left hip prosthesis secondary to a <jats:italic>Staphylococcus capitis<\/jats:italic> infection, whose spacer was found to be infected by <jats:italic>Candida albicans<\/jats:italic> at a later time. Briefly, the patient underwent revision surgery of the hip prosthesis for a suspected PJI. After the debridement of the infected tissue, an antibiotic-loaded spacer was implanted. The microbiological analysis of the periprosthetic tissues and the implant depicted a <jats:italic>S. capitis<\/jats:italic> infection that was treated according to the antimicrobial susceptibility profile of the clinical isolate. Three months later, the patient was admitted to the emergency room due to local inflammatory signs. Synovial fluid was sent to the laboratory for culture. No evidence of <jats:italic>S. capitis<\/jats:italic> was detected, however, a yeast was identified as <jats:italic>Candida albicans<\/jats:italic>. Fifteen days later, the patient was hospitalized for the removal of the infected spacer. Microbiological cultures confirmed the results of the synovial fluid analysis. According to the susceptibility profile, the patient was treated with fluconazole (400\u2009mg\/day) for 6 months. Seven months later, the patient underwent second-stage surgery. The microbiological tests on the spacer were all negative. After 12\u2009months of follow-up, the patient has fully recovered and no radiological signs of infection have been detected.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Given the exceptionality of this complication, it is important to report these events to better understand the clinical outcomes after the selected therapeutic options to prevent and forestall the development of either bacterial or fungal spacer infections.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06113-8","type":"journal-article","created":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T10:03:07Z","timestamp":1620122587000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A spacer infection by Candida albicans secondary to a Staphylococcus capitis prosthetic joint infection: a case report"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8105-5959","authenticated-orcid":false,"given":"Marta","family":"Bottagisio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Bidossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Logoluso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Pellegrini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"De Vecchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,4]]},"reference":[{"issue":"7","key":"6113_CR1","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1302\/2058-5241.4.180092","volume":"4","author":"P Izakovicova","year":"2019","unstructured":"Izakovicova P, Borens O, Trampuz A. Periprosthetic joint infection: current concepts and outlook. EFORT open reviews. 2019;4(7):482\u201394. https:\/\/doi.org\/10.1302\/2058-5241.4.180092.","journal-title":"EFORT open reviews"},{"issue":"2","key":"6113_CR2","doi-asserted-by":"publisher","first-page":"76","DOI":"10.7150\/jbji.40402","volume":"5","author":"T Riaz","year":"2020","unstructured":"Riaz T, Tande AJ, Steed LL, Demos HA, Salgado CD, Osmon DR, et al. Risk factors for fungal prosthetic joint infection. Journal of bone and joint infection. 2020;5(2):76\u201381. https:\/\/doi.org\/10.7150\/jbji.40402.","journal-title":"Journal of bone and joint infection"},{"issue":"1","key":"6113_CR3","doi-asserted-by":"publisher","first-page":"74","DOI":"10.2106\/JBJS.17.01103","volume":"101","author":"SM Petis","year":"2019","unstructured":"Petis SM, Abdel MP, Perry KI, Mabry TM, Hanssen AD, Berry DJ. Long-term results of a 2-stage exchange protocol for Periprosthetic joint infection following Total hip Arthroplasty in 164 hips. 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A copy of the written consent is available for review by the Editor of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"416"}}