Disseminated Infection of Encephalitozoon cuniculi Associated With Osteolysis of Hip Periprosthetic Tissue: Association Versus Causation

Kicia et al report an association between Encephalitozoon species and osteolysis of prosthetic hip implants in a small cohort of patients with presumed aseptic failure. Hip arthroplasty is the fourth most common operating procedure for inpatient stays in the United States, and periprosthetic joint infection is one of the most common indications for revision surgery [1]. The diagnosis of periprosthetic infections is imperfect, and the underlying causative agent may fail to be identified. The results presented by Kicia et al are therefore relevant and potentially of significance.