title: Candida tropicalis arthritis of the knee in a patient with acute lymphoblastic leukaemia: successful treatment with caspofungin.
abstract: Candida arthritis in patients with a haematological malignancy is rare. We report a case of Candida tropicalis arthritis of the knee that occurred in a patient with acute lymphoblastic leukaemia during the recovery phase of post-chemotherapy neutropenia. Although the Candida tropicalis isolates from synovial fluid and synovial tissue were sensitive to fluconazole in vitro, a 6-week course of oral treatment failed to produce clinical improvement. The arthritis resolved after 7 weeks of combination therapy with caspofungin, a new echinocandin class of antifungal agent that acts primarily on the cell wall. Eleven other reports of Candida arthritis in patients with a haematological malignancy were reviewed.
authors.affiliation: Department of Medicine, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong. joycelynpysim@hotmail.com
authors.forename: J P Y
authors.initials: JP
authors.lastname: Sim
authors.forename: B C S
authors.initials: BC
authors.lastname: Kho
authors.forename: H S Y
authors.initials: HS
authors.lastname: Liu
authors.forename: R
authors.initials: R
authors.lastname: Yung
authors.forename: J C W
authors.initials: JC
authors.lastname: Chan
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000188:drug therapy* / Q000209:etiology; D041022:Candida tropicalis / Q000302:isolation & purification*; D002177:Candidiasis / Q000188:drug therapy* / Q000209:etiology; D000077336:Caspofungin; D054714:Echinocandins; D006801:Humans; D007717:Knee; D055666:Lipopeptides; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D000077336:Caspofungin