title: Multifocal osteoarthritis due to Candida albicans in a neonate: serum level monitoring of liposomal amphotericin B and literature review.
abstract: A 32-week neonate weighing 2,300 g at birth with fungemia due to Candida albicans subsequently developed multifocal osteoarthritis of the lower extremities due to the same organism during therapy with amphotericin B (0.5 mg/kg/day) and flucytosine (100 mg/kg/day) to which the isolates were susceptible. Liposomal amphotericin B (3.5 mg/kg/day) was substituted for conventional amphotericin B and complete clinical and radiologic recovery as well as sterilization of affected joints were achieved with a 38-day-course (144.5 mg/kg total). Adequate drug concentrations in serum and synovial fluid were attained with liposomal amphotericin B. Nine neonates (< or = 28 days of age) with bone and/or joint infections due to Candida spp. had previously been reported in the English-language literature. To our knowledge, the present case is the first reported cure with liposomal amphotericin B. Previous cases are reviewed and the potential role of liposomal amphotericin B in this serious neonatal infection is discussed.
authors.affiliation: Dept. of Neonatology, University of Thessaloniki, Hippokration Hospital, Greece.
authors.forename: J
authors.initials: J
authors.lastname: Evdoridou
authors.forename: E
authors.initials: E
authors.lastname: Roilides
authors.forename: E
authors.initials: E
authors.lastname: Bibashi
authors.forename: G
authors.initials: G
authors.lastname: Kremenopoulos
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage* / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D001842:Bone and Bones / Q000000981:diagnostic imaging; D002177:Candidiasis / Q000175:diagnosis* / Q000188:drug therapy*; D004337:Drug Carriers; D004359:Drug Therapy, Combination; D005437:Flucytosine / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008081:Liposomes; D008297:Male; D008826:Microbial Sensitivity Tests; D010003:Osteoarthritis / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D011859:Radiography
chemical_list: D000935:Antifungal Agents; D004337:Drug Carriers; D008081:Liposomes; D000666:Amphotericin B; D005437:Flucytosine