Candida tropicalis arthritis of the knee in a patient with acute lymphoblastic leukaemia: successful treatment with caspofungin

Hong Kong Med J. 2005 Apr;11(2):120-3.

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.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use*
  • Arthritis, Infectious / drug therapy*
  • Arthritis, Infectious / etiology
  • Candida tropicalis / isolation & purification*
  • Candidiasis / drug therapy*
  • Candidiasis / etiology
  • Caspofungin
  • Echinocandins
  • Humans
  • Knee*
  • Lipopeptides
  • Male
  • Middle Aged
  • Peptides, Cyclic / therapeutic use*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*

Substances

  • Antifungal Agents
  • Echinocandins
  • Lipopeptides
  • Peptides, Cyclic
  • Caspofungin