{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T08:37:44Z","timestamp":1762331864163,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Total knee arthroplasty is an increasingly common surgical intervention for degenerative knee disease, yet it carries a risk of prosthetic joint infection (PJI). While bacterial infections dominate the landscape of PJIs, fungal infections represent a rare but significant concern, especially in immunocompromised patients. This case report describes a 71-year-old patient who presented in October 2024 with left knee pain and swelling 7 months after total knee arthroplasty. A prosthetic joint infection due to Candida parapsilosis was diagnosed preoperatively by repetitive microbiological examination of synovial fluid and intraoperatively by tissue samples and sonication of prosthetic material. A two-stage revision surgery with a short 4-week interval was performed using an antifungal-impregnated spacer, followed by 6 months of systemic antifungal treatment with fluconazole and continued by fluconazole suppressive treatment for another 6 months. A favorable clinical and functional outcome was achieved after 11 months of follow-up. This is a rare case of fungal PJI treatment with a two-stage revision with a shorter interval, using an antifungal impregnated spacer combined with a prolonged antifungal therapy.<\/jats:p>","DOI":"10.3390\/antibiotics14111112","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T07:58:05Z","timestamp":1762329485000},"page":"1112","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fungal Prosthetic Joint Infection by Candida parapsilosis After Total Knee Arthroplasty"],"prefix":"10.3390","volume":"14","author":[{"given":"Zmago","family":"Krajnc","sequence":"first","affiliation":[{"name":"University Department of Orthopaedics, University Medical Centre Maribor, 2000 Maribor, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klemen","family":"\u017ditek","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, General Hospital Murska Sobota, 9600 Murska Sobota, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Gori\u0161ek Miksi\u0107","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Febrile Conditions, University Medical Centre Maribor, 2000 Maribor, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e22.00112","DOI":"10.2106\/JBJS.OA.22.00112","article-title":"Projections and Epidemiology of Primary Hip and Knee Arthroplasty in Medicare Patients to 2040-2060","volume":"8","author":"Shichman","year":"2023","journal-title":"JBJS Open Access"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/cis803","article-title":"Diagnosis and management of prosthetic joint infection: Clinical practice guidelines by the Infectious Diseases Society of America","volume":"56","author":"Osmon","year":"2013","journal-title":"Clin. 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