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Candida tropicalis arthritis of the knee
in a patient with acute lymphoblastic leukaemia: successful treatment
with caspofungin
JPY Sim, BCS Kho, HSY Liu,
R Yung, JCW Chan
Department of Medicine, Pamela Youde Nethersole Eastern Hospital,
3 Lok Man Road, Chai Wan, Hong Kong
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.
Hong Kong Med J 2005;11:120-3
Key words: Antifungal agents; Arthritis, infectious;
Candidiasis; Knee joint; Leukemia, lymphocyte, acute
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