First Reported Case of Prosthetic Joint Infection Caused by Lomentospora prolificans in an Immunocompetent Host
10.14192/kjicp.2025.30.1.76
- Author:
Yoonjung LEE
1
;
Soosung KIM
;
Hong Yeol YANG
;
Ahrang LEE
;
Minji KIM
;
Hae Seong JEONG
;
Sung Un SHIN
;
Uh Jin KIM
;
Kyung-Hwa PARK
;
Sook-In JUNG
;
Seung Ji KANG
Author Information
1. Department of Infectious Diseases, Chonnam National University Bitgoeul Hospital, Gwangju, Korea
- Publication Type:Case Report
- From:
Korean Journal of healthcare-associated Infection Control and Prevention
2025;30(1):76-80
- CountryRepublic of Korea
- Language:English
-
Abstract:
Lomentospora prolificans is a rare opportunistic mold with high intrinsic resistance to most antifungal agents. It causes disseminated infections in immunocompromised patients and localized infections in immunocompetent hosts, often involving the bones, joints, or skin. However, prosthetic joint infections (PJI) due to L. prolificans have not been previously reported.Here, we describe the first case of L. prolificans PJI in an immunocompetent 51-year-old male patients, who had no significant comorbidities other than hypertension. The patient presented with right knee pain and swelling one year after total knee arthroplasty. Cultures of the joint fluid and periprosthetic tissue yielded L. prolificans, as confirmed by matrix-assisted laser desorption ionization–time-of-flight mass spectrometry (MALDI-TOF MS) and rRNA gene sequencing. Susceptibility testing showed high minimum inhibitory concentrations for most currently available antifungal agents, including azoles, amphotericin B, echinocandins, and terbinafine. Despite prosthesis removal, multiple surgical debridements, and prolonged antifungal therapy, including voriconazole and terbinafine, the infection persisted over a five-year period.Amputation was discussed as a potential curative measure; however, no consensus has been reached due to its long-term impact. This case highlights the clinical challenges of managing L. prolificans PJI and underscores the need for novel antifungal therapies to treat rare drugresistant fungal infections.
