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This report describes a 58-year-old insulin-dependent diabetic male patient who initially sustained a proximal humerus fracture from a fall. The fracture fixation failed and then was converted to a humeral hemiarthroplasty, which became infected with  Candida glabrata  and  Serratia marcescens . After these infections were believed to be cured with antibacterial and antifungal treatments and two-stage irrigation and debridement, he underwent conversion to a reverse total shoulder arthroplasty. Unfortunately, the  C. glabrata  infection recurred and, nearly 1.5 years after implantation of the reverse total shoulder, he had a resection arthroplasty (removal of all implants and cement). His surgical and pharmacologic treatment concluded with (1) placement of a tobramycin-impregnated cement spacer also loaded with amphotericin B, with no plan for revision arthroplasty (i.e., the spacer was chronically retained), and (2) chronic use of daily oral fluconazole. We located only three reported cases of  Candida  species causing infection in shoulder arthroplasties (two  C. albicans , one  C. parapsilosis ). To our knowledge, a total shoulder arthroplasty infected with  C. glabrata  has not been reported, nor has a case of a  C. glabrata  and  S. marcescens  periprosthetic coinfection in any joint. In addition, it is well known that  S. marcescens  infections are uncommon in periprosthetic joint infections.

Failed Reverse Total Shoulder Arthroplasty Caused by RecurrentCandida glabrataInfection with PriorSerratia marcescensCoinfection