Abstract

Candida albicans arthritis is uncommon. Although occasional instances of meningitis, osteomyelitis, endocarditis, pneumonia, and extensive visceral involvement due to Candida species have been reported, only 7 documented cases of arthritis caused by Candida albicans are found in the literature. The present case was an infant with a gastroschisis defect of the abdominal wall, who required multiple surgical procedures, prolonged antibiotic therapy, and parental intravenous hyperalimentation. Following a blood stream infection with Candida albicans, septic arthritis of the left knee developed. Treatment with intravenous Amphotericin-B over a 6-week period was successful in eridicating the infection. The child is completely well 9 months after discharge from the hospital. Factors which may predispose patients to infection by Candida albicans include prolonged antibiotic therapy. corticosteroids, generalized debilitation, malnutrition, parental hyperalimentation, and immunosuppressive therapy. Amphotericin-B therapy may be associated with considerable toxicity including azotemia, hepatic dysfunction, and hematologic abnormalities. The therapeutic regimen of Amphotericin-B is effective but a 6-week course of antifungal therapy may be necessary to eradicate septic arthritis of Candida albicans. Surgical drainage is probably indicated only for recent infections.