{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:45:31Z","timestamp":1782909931583,"version":"3.54.5"},"reference-count":73,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T00:00:00Z","timestamp":1728864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Data regarding fungal PJIs of the shoulder are scarce. The present systematic review aims to identify and evaluate all published shoulder fungal PJIs in an effort to better understand the diagnostic and therapeutic approach to these infections. Methods: A systematic review according to the PRISMA guidelines was conducted, locating all shoulder fungal PJIs. The initial search located 1435 articles. Data were collected on demographics, the causative fungus, antifungal treatment (AFT), surgical interventions, and infection outcomes. Results: After screening and implementation of the inclusion criteria, a total of 10 articles, including 10 cases, were eligible. The sample\u2019s mean age was 62.44 years. Diabetes mellitus was the most common comorbidity (30%), while 70% were immunocompromised. Candida spp. was the most common causative fungus (nine cases; 90%), while all cases were confirmed with cultures. In three cases (30%), there was bacterial co-infection. The mean duration of antifungal treatment (AFT) was 8.4 weeks, while the preferred agent was fluconazole (60% of cases), followed by amphotericin B (30%). Most cases (50%) underwent resection arthroplasty as part of the treatment, while two-stage revision arthroplasty was performed in 30%. Infection\u2019s eradication was reported in 90% of the studied cases. Conclusions: The diagnosis and management of fungal periprosthetic shoulder infections are particularly challenging and require a multidisciplinary approach. The combination of antifungal therapy and tailored surgical strategies is crucial, but further research is needed to refine treatment protocols and address the unique considerations in shoulder PJIs.<\/jats:p>","DOI":"10.3390\/jcm13206128","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T07:28:35Z","timestamp":1729495715000},"page":"6128","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Fungal Shoulder Periprosthetic Infections: A Systematic Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2828-4661","authenticated-orcid":false,"given":"Vasileios","family":"Giovanoulis","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, H\u00f4pital Henri Mondor, AP-HP, Universit\u00e9 Paris Est Cr\u00e9teil (UPEC), 94010 Creteil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3218-6747","authenticated-orcid":false,"given":"Vasileios","family":"Pastamentzas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, \u201c251\u201d Hellenic Air Force General Hospital of Athens, 11525 Athina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1289-4959","authenticated-orcid":false,"given":"Enejd","family":"Veizi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, Ankara City Hospital, Ankara 2367, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8350-9069","authenticated-orcid":false,"given":"Charalampos","family":"Matzaroglou","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Symeon","family":"Naoum","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Royal Berkshire Hospital, Reading RG1 5AN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Samonis","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Crete, 71003 Heraklion, Greece"},{"name":"First Department of Medical Oncology, Metropolitan Hospital of Neon Faliron, 18547 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4831-8005","authenticated-orcid":false,"given":"Maria","family":"Piagkou","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 15772 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios V.","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"2nd Academic Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, 14233 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3695-0759","authenticated-orcid":false,"given":"Andreas G.","family":"Tsantes","sequence":"additional","affiliation":[{"name":"Microbiology Department, \u201cSaint Savvas\u201d Oncology Hospital, 11522 Athens, Greece"},{"name":"Laboratory of Hematology and Blood Bank Unit, \u201cAttikon\u201d University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1398-9626","authenticated-orcid":false,"given":"Christos","family":"Koutserimpas","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 15772 Athens, Greece"},{"name":"Orthopaedic Surgery and Sports Medicine Department, Croix Rousse, University Hospital of Lyon, 69004 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"l298","DOI":"10.1136\/bmj.l298","article-title":"Serious adverse events and lifetime risk of reoperation after elective shoulder replacement: Population based cohort study using hospital episode statistics for England","volume":"364","author":"Craig","year":"2019","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"133","DOI":"10.5435\/JAAOS-D-16-00720","article-title":"Trends and Variability in the Use of Total Shoulder Arthroplasty for Medicare Patients","volume":"26","author":"Zmistowski","year":"2018","journal-title":"J. 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