Fungal prosthetic arthritis: presentation of two cases and review of the literature.

Fungal infections complicating reconstructive arthroplasty are extremely rare, with only six previously reported cases. These infections follow an indolent course and involve pain without inflammation in the affected joint, often as late as 2 years after surgery. Candida species other than Candida albicans are the commonest fungal pathogens and represent intraoperative contaminants. The diagnosis is made difficult by the indolent course and the frequent interpretation of the fungal isolate as a culture contaminant. Therapy requires resection of the prosthetic components with debridement; the additional need for antifungal therapy remains unclear.