Identification of the Pathogen Causing Prosthetic Joint Infection by Candida tropicalis through Metagenomic Sequencing

Periprosthetic joint infection (PJI) is a serious complication following total knee arthroplasty. Fungal infections tend to form biofilms, making it challenging to diagnose and identify the specific pathogenic strains. A patient who underwent surgery for progressive osteoarthritis two years ago presented with persistent postoperative pain and swelling. Knee joint revision surgery was performed, and during the procedure, bacterial and fungal factor sequences were analyzed using metagenomic sequencing, which successfully identified a fungal strain belonging to the Candida tropicalis genus. Based on the identification results, appropriate antifungal treatment was administered, followed by a second-stage surgical intervention. During the second surgery, metagenomic sequencing was performed again, but no definitive pathogenic bacteria were found.