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September 26, 1977

Flucytosine Treatment of Candida Arthritis

JAMA. 1977;238(13):1395-1396. doi:10.1001/jama.1977.03280140073026

THE INCIDENCE of systemic candidiasis in hospitalized patients has risen markedly in the past decade,1 but its occurrence is almost solely confined to persons with serious underlying disease or therapy that compromises host defense mechanisms. Septic arthritis is occasionally seen with systemic candidiasis, but isolated arthritis (without evidence of other Candida infection) is rare. We herein report the third documented case of isolated Candida arthritis; treatment with a short course of amphotericin B and then prolonged oral flucytosine was successful.

Report of a Case  A 75-year-old woman was referred to University Hospitals for treatment of suppurative arthritis. She had been receiving intra-articular steroid injections (beta-methasone, 0.25 ml, and triamcinolone hexacetonine, 1.25 ml) for degenerative arthritis of the knees since 1965. In 1973, a painful effusion developed in the left knee and Candida parapsilosis was isolated.