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September 3, 1982

Candida tropicalis Arthritis and Bursitis

Author Affiliations

From the Department of Medicine, Divisions of Rheumatology (Drs Wall and Weinblatt), Infectious Diseases (Dr Darnall), and Oncology (Dr Muss), Bowman Gray School of Medicine, Winston-Salem, NC. Dr Weinblatt is currently with the Beth Israel Hospital, Boston. Dr Darnall is currently with the Taylor Hospital, Ridley Park, Pa.

JAMA. 1982;248(9):1098-1099. doi:10.1001/jama.1982.03330090068034

INFECTIONS with Candida organisms have been noted with increasing frequency in immunocompromised patients; however, arthritis rarely occurs. Candida arthritis has been treated with systemic antifungal medications with good results. We report a patient with Candida tropicalis arthritis and bursitis whose condition did not respond to multiple antifungal drugs and synovectomy. Control of the infection occurred only after bursectomy and arthrodesis.

Report of a Case  A 48-year-old man was found to have a poorly differentiated lymphocytic lymphoma confined to the bone marrow, in October 1979. Treatment with vincristine sulfate and prednisone was unsuccessful, but there was an excellent response to highdose methotrexate and leucovorin calcium rescue, with almost complete clearing of malignant cells. He was subsequently given combination chemotherapy with cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone (CHOP-BLEO antineoplastic regimen). In spite of an excellent response and normal performance status, complete remission was never achieved, and repeated bone marrow aspirations always showed