Failed Reverse Total Shoulder Arthroplasty Caused by Recurrent Candida glabrata Infection with Prior Serratia marcescens Coinfection

Table 1

Susceptibility results of our patient’s C. glabrata isolates to various antifungal drugs at the time of revision from the ORIF to the hemiarthroplasty and one week prior to the resection arthroplasty of the reverse total shoulder arthroplasty (RTSA).

Drug	3 weeks after injury (revision to hemiarthroplasty)	19 months after RTSA (1 week prior to removal)
Fluconazole^*	8	4
Micafungin	≤0.008	≤0.008
Caspofungin	0.06	0.12
Voriconazole^*	0.12	0.12
5-Fluorocytosine	≤0.06	≤0.06
Anidulafungin	≤0.03	≤0.016
Itraconazole^*	0.5	0.25
Posaconazole	1	0.5
Amphotericin B^†	≤0.5	≤0.5

For fluconazole, itraconazole, and voriconazole, the susceptibility is dose dependent where the maximum possible level must be achieved (here the level for fluconazole is <32).
^†For amphotericin B, an MIC >1 μg/mL is considered resistant.