Treatment of Candida arthritis with flucytosine and amphotericin B.
A premature infant with disseminated Candida tropicalis infection with arthritis and osteomyelitis is presented. Although the organism was susceptible to amphotericin B, synovial fluid cultures were still positive for yeast after 2 weeks of intravenous amphotericin B therapy. The addition of oral flucytosine (25 mg/kg four times daily) resulted in sterilization of the synovial fluid within 4 days. Simultaneous serum and synovial levels of flucytosine were 47.5 micrograms/ml and 39.6 micrograms/ml, respectively. This is the first documentation in the medical literature of intraarticular levels of flucytosine, and provides further rationale for the use of flucytosine in addition to amphotericin B in patients with Candida arthritis.
Weisse
M E
ME
Department of Pediatrics, Tripler Army Medical Center, Honolulu, Hawaii.
Person
D A
DA
Berkenbaugh
J T
JT
D000666:Amphotericin B / Q000008:administration & dosage*; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000188:drug therapy*; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005437:Flucytosine / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male
D000666:Amphotericin B; D005437:Flucytosine