Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA.
Citations 1
Fungal Periprosthetic Joint Infection: A Systematic Review and Meta-Analysis of Treatment Approaches and Clinical Outcomes
Open Forum Infectious Diseases | October 2, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Fungal periprosthetic joint infection (PJI) is a rare but serious complication of joint arthroplasty, with variable management and poorly defined outcomes. We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines, searching Ovid MEDLINE, Embase, Scopus, and Ovid Cochrane Central. Cohort studies were included in the quantitative synthesis, while case reports and series were reviewed qualitatively. Outcomes were treatment success, failure, reinfection, and mortality. We included 160 studies: 42 cohort studies and 118 case reports or case series, with 1,025 fungal PJI cases. Pooled rates were 66.5% for treatment success, 36.5% for failure, 16.6% for reinfection, and 9.6% for mortality. Success and failure were extracted independently using study-specific definitions and are not necessarily complementary. Treatment-strategy estimates were descriptive; studies reporting DAIR had lower pooled success, but findings should be interpreted cautiously because of differences in patient selection, study design, and outcome definitions. These findings cannot establish comparative effectiveness.