Skip to main content
SpringerLink
Log in

Candida tropicalis arthritis in a patient with acute myeloid leukemia successfully treated with fluconazole: Case report and review of the literature

  • Brief Report
  • Published:
Infection Aims and scope Submit manuscript

Summary

The case of a 77-year-old woman with acute myeloid leukemia who developedCandida tropicalis septic arthritis of the knee after remission-inducing chemotherapy is reported. A literature review ofC. tropicalis non-prosthetic arthritis is included. The isolate was susceptible to fluconazole (MIC 0.25 mg/l). She was treated with fluconazole (400 mg orally) and frequent relieving synovial aspirations. After 1 month of antifungal therapy the synovial fluid became culture negative. Fluconazole concentration in the synovial fluid and serum were 20 mg/l and 19.4 mg/l, respectively. The patient was treated for a total of 7 months and made a full recovery. This is the first report of the successful use of fluconazole in the treatment of septic arthritis due toC. tropicalis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Wingard, J. R., Merz, W. G., Saral, R. Candida tropicalis: A major pathogen in immunocompromised patients. Ann. Intern. Med. 91 (1979) 539–543.

    PubMed  Google Scholar 

  2. Rex, J. H., Bennett, J. E., Sugar, A. M., Pappas, P. G., van der Horst, C. M., Edwards, J. E., Washburn, R. G., Scheld, W. M., Karchmer, A. W., Dine, A. P., Levenstein, M. J., Webb, C. D., forthe Candidemia Study Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group A randomized trial comparing fluconazole with amphotericin B for the treatment of candidemia in patients without neutropenia. N. Engl. J. Med. 331 (1994) 1325–1330.

    Article  PubMed  Google Scholar 

  3. Anaissie, E., Paetznick, V., Bodey, G. P. Fluconazole susceptibility testing ofCandida albicans: microtiter method that is independent of inoculum size, temperature, and time of reading. Antimicrob. Agents Chemother. 35 (1991) 1641–1646.

    PubMed  Google Scholar 

  4. National Committee for Clinical Laboratory Standards Reference method for broth dilution antifungal susceptibility testing of yeasts; proposed standard, NCCLS document M27-P (1992), Villanova, Pennsylvania, USA.

    Google Scholar 

  5. Wallace, J. E., Harris, S. C., Gallegos, J., Foulds, G., Chen, T. J. H., Rinaldi, M. G. Assay of fluconazole by high performance liquid chromatography with a mixed-phase column. Antimicrob. Agents Chemother. 36 (1992) 603–606.

    PubMed  Google Scholar 

  6. Cuende, E., Barbadillo, C., E-Mazzucchelli, R., Isasi, C., Trujillo, A., Andréu, J. L. Candida arthritis in adult patients who are not intravenous drug addicts: report of three cases and review of literature. Semin. Arthritis Rheum. 22 (1993) 224–241.

    PubMed  Google Scholar 

  7. Christensson, B., Ryd, L., Dahlberg, L., Lohmander, S. Candida albicans arthritis in a nonimmunocompromised patient. Complication of placebo intraarticular injections. Acta. Orthop. Scand. 64 (1993) 695–698.

    PubMed  Google Scholar 

  8. Munoz-Fernandez, S., Maciá, M. A., Pantoja, L., Cardenal, A., Pena, J. M., Martin Mola, E., Balsa, A., Barbado, F. J., Vázquez, J. J., Gijón Banos, J. Osteoarticular infection in intravenous drug abusers: influence of HIV infection and differences with non drug abusers. Ann. Rheum. Dis. 52 (1993) 570–574.

    PubMed  Google Scholar 

  9. Nouyrigat, P., Baume, D., Blaise, D., Revillon, D., Gabus, R., Miquel, M., Maraninchi, D. Candida arthritis treated with intra-articular amphotericin B. Eur. J. Med. 2 (1993) 124–125.

    PubMed  Google Scholar 

  10. Barbara, J. A., Clarkson, A. R., LaBrooy, J., McNeil, J. D., Woodroffe, A. J. Candida albicans arthritis in a renal allograft recipient with an interaction between cyclosporin and fluconazole. Nephrol. Dial. Transplant. 8 (1993) 263–266.

    PubMed  Google Scholar 

  11. Silveira, L. H., Cuéllar, M. L., Citera, G., Cabrera, G. E., Scopelitis, E., Espinoza, L. R. Candida arthritis. Rheum. Dis. Clin. North Am. 19 (1993) 427–437.

    PubMed  Google Scholar 

  12. Murray, H. W., Fialk, M. A., Roberts, R. B. Candida arthritis. Manifestation of disseminated candidiasis. Am. J. Med. 60 (1976) 587–595.

    Article  PubMed  Google Scholar 

  13. Bayer, A. S., Guze, L. B. Fungal arthritis I: diagnostic and prognostic implications and therapeutic considerations. Semin. Arthrit. Rheum. 8 (1978) 142–150.

    Article  Google Scholar 

  14. Fainstein, V., Gilmore, C., Hopfer, R. L., Maksymiuk, A., Bodey, G. P. Septic arthritis due toCandida species in patients with cancer: report of five cases and review of the literature. Rev. Infect. Dis. 4 (1982) 78–85.

    PubMed  Google Scholar 

  15. Mandel, D. R., Segal, A. M., Wysenbeek, A. J., Calabrese, L. H. Two unusual strains ofCandida arthritis. Am. J. Med. Sci. 288 (1984) 25–27.

    PubMed  Google Scholar 

  16. Weisse, M. E., Person, D. A., Berkenbaugh Jr., J. T. Treatment ofCandida arthritis with flucytosine and amphotericin B. J. Perinatol. 13 (1993) 402–404.

    PubMed  Google Scholar 

  17. Wingard, J. R., Dick, J. D., Merz, W. G., Sandford, W. G., Saral, R., Burns, W. H. Differences in virulence of clinical isolates ofCandida tropicalis andCandida albicans in mice. Infect. Immun. 37 (1982) 833–836.

    PubMed  Google Scholar 

  18. Fromtling, R. A., Abruzzo, G. K., Giltinan, D. N. Candida tropicalis infection in normal, diabetic, and neutropenic mice. J. Clin. Microbiol. 25 (1987) 1416–1420.

    PubMed  Google Scholar 

  19. Walsh, T. J., Merz, W. G. Pathologic features in the human alimentary tract associated with invasiveness ofCandida tropicalis. Am. J. Clin. Pathol. 85 (1986) 498–502.

    PubMed  Google Scholar 

  20. Ferra, C., Doebbeling, B. N., Hollis, R. J., Pfaller, M. A., Lee, C. K., Gingrich, R. D. Candida tropicalis vertebral osteomyelitis: a late sequela of fungemia. Clin. Infect. Dis. 19 (1994) 697–703.

    PubMed  Google Scholar 

  21. De Pauw, B. E., Raemakers, J. M. M., Donnelly, J. P., Kullberg, B. J., Meis, J. F. G. M. An open study on the safety and efficacy of fluconazole in the treatment of disseminatedCandida infections in patients treated for hematological malignancy. Ann. Hematol. 70 (1995) 83–87.

    Article  PubMed  Google Scholar 

  22. O'Meeghan, T., Varcoe, R., Thomas, M., Ellis-Pegler, R. Fluconazole concentration in joint fluid during successful treatment ofCandida albicans septic arthritis (letter). J. Antimicrob. Chemother. 26 (1990) 601–602.

    PubMed  Google Scholar 

  23. Tang, C. Successful treatment ofCandida albicans osteomyelitis with fluconazole. J. Infect. 26 (1993) 89–92.

    Article  PubMed  Google Scholar 

  24. Tunkel, A. R., Thomas, C. Y., Wispelwey, B. Candida prosthetic arthritis: report of a case treated with fluconazole and review of the literature. Am. J. Med. 94 (1993) 100–103.

    Article  PubMed  Google Scholar 

  25. Paul, J., White, S. H., Nicholls, K. M., Crook, D. W. Prosthetic joint infection due toCandida parapsilosis in the UK: case report and literature review. Eur. J. Clin. Microbiol. Infect. Dis. 11 (1992) 847–849.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dept. of Medical Microbiology, Bosch Medicentrum, Den Bosch

    G. Weers-Pothoff M. D.

  2. Dept. of Rheumatology, Bosch Medicentrum, Den Bosch

    J. F. Havermans M. D.

  3. Dept. of Internal Medicine, Bosch Medicentrum, Den Bosch

    J. Kamphuis M. D. & H. A. M. Sinnige M. D.

  4. Dept. of Medical Microbiology, MMB 440 University Hospital Nijmegen, P. O. Box 9101, NL-6500 HB, Nijmegen, The Netherlands

    J. F. G. M. Meis M. D.

Authors
  1. G. Weers-Pothoff M. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. F. Havermans M. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Kamphuis M. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. A. M. Sinnige M. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. F. G. M. Meis M. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Weers-Pothoff, G., Havermans, J.F., Kamphuis, J. et al. Candida tropicalis arthritis in a patient with acute myeloid leukemia successfully treated with fluconazole: Case report and review of the literature. Infection 25, 109–111 (1997). https://doi.org/10.1007/BF02113588

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02113588

Keywords

Search

Navigation