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November 25, 1983

Nosocomial Fungemia in a Normal Host

Author Affiliations

Springfield Clinic Springfield, III

JAMA. 1983;250(20):2791. doi:10.1001/jama.1983.03340200025016

To the Editor.—  Fungemias are occasional complications of diseases of immunosuppression. Disseminated histoplasmosis, blastomycosis, and coccidioidomycosis are known to occur in otherwise normal hosts, and recently D'Silva et al reported a case of disseminated aspergillosis in a presumably immunocompetent host (1982;248:1495). However, nosocomial fungemia is thought to relate to immune disorders.1 This report describes an apparently healthy patient in whom Candida tropicalis fungemia developed.

Report of a Case.—  A 56-year-old man with mild cerebral palsy fell on Feb 3, 1982, and sustained a comminuted fracture of the right hip. The hip was fixed internally with a Zimmer key-free screw and plate. The wound drained for two weeks and closed secondarily. Pain continued in the hip for the next five months, but the patient remained afebrile. A roentgenogram on July 20 indicated migration of the prosthesis, so it was removed; culture of the purulent bone yielded Staphylococcus aureus. He was