Gross CE, Valle CJD, Rex JC, et al. - Although the occurrence of periprosthetic joint infection (PJI), the most feared complications of total joint arthroplasty (TJA), is commonly correlated with colonization by Staphylococcal species, there are reports of a growing number of cases of PJI with fungal pathogens within the last decade. The standard treatment with two-stage exchange mirrors that of bacterial PJI, however, the treatment course may be unpredictable and challenging due to variation in virulence of fungal species. Reviewing Pubmed and Scopus from years 2009 to 2019 using the search terms fungal, infection, Candida, arthroplasty, periprosthetic, and prosthesis, they obtained data for 286 patients with fungal PJI in the hip, knee, shoulder, and elbow prosthetics. Findings overall favor two-stage exchange to treat fungal PJI. They do not suggest adequacy of debridement with implant retention to control infection, and support prioritizing retrieval of implanted materials. For ongoing research, the use of antifungal impregnated spacers is an important area, with uncertainty concerning the type and quantity of antifungal agent to incorporate, although the use of these agents is supported in recent reports.