1887

Abstract

Invasive candidiasis is rare in children after the neonatal period, but can occur in children with (secondary) immunodeficiency with a damaged gastrointestinal or skin barrier, or when receiving antibiotics. A 10-month-old girl was diagnosed as suffering from cystic fibrosis (CF) when showing failure to thrive, pulmonary symptoms and hypoproteinaemia. At that time, was identified from blood culture and treated intravenously with liposomal amphotericin B for 13 days. Six weeks later, the girl presented with osteoarticular infection of the left knee caused by . The infection showed insufficient response to therapy with liposomal amphotericin B, but the patient recovered after therapy with fluconazole and flucytosine. Follow-up over 4 years revealed no sequelae. In conclusion, invasive infections may occur in patients with CF, and preventive measures might be considered in patients at risk. In the case of an invasive infection, prolonged treatment with a combination of antifungal drugs may be required.

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2011-10-01
2024-04-28
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References

  1. Chotirmall S. H., O’Donoghue E., Bennett K., Gunaratnam C., O’Neill S. J., McElvaney N. G. 2010; Sputum Candida albicans presages FEV? decline and hospital-treated exacerbations in cystic fibrosis. Chest 138:1186–1195 [View Article][PubMed]
    [Google Scholar]
  2. Fischman A. J., Alpert N. M., Livni E., Ray S., Sinclair I., Callahan R. J., Correia J. A., Webb D., Strauss H. W., Rubin R. H. 1993; Pharmacokinetics of 18F-labeled fluconazole in healthy human subjects by positron emission tomography. Antimicrob Agents Chemother 37:1270–1277[PubMed] [CrossRef]
    [Google Scholar]
  3. Lambertus M., Thordarson D., Goetz M. B. 1988; Fungal prosthetic arthritis: presentation of two cases and review of the literature. Rev Infect Dis 10:1038–1043 [View Article][PubMed]
    [Google Scholar]
  4. NCCLS 2002a Reference Method for Broth Dilution Susceptibility Testing of Yeasts NCCLS approved standard M27-A2 Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  5. NCCLS 2002b Reference Method for Antifungal Disk Diffusion Susceptibility Testing of Yeasts NCCLS proposed guideline M44-A Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  6. Pappas P. G., Rex J. H., Sobel J. D., Filler S. G., Dismukes W. E., Walsh T. J., Edwards J. E. 2004; Guidelines for treatment of candidiasis. Clin Infect Dis 38:161–189 [View Article][PubMed]
    [Google Scholar]
  7. Pappas P. G., Kauffman C. A., Andes D., Benjamin D. K. Jr, Calandra T. F., Edwards J. E. Jr, Filler S. G., Fisher J. F., Kullberg B. J. et al. 2009; Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 48:503–535 [View Article][PubMed]
    [Google Scholar]
  8. Pérez-Gómez A., Prieto A., Torresano M., Díez E., Mulero J., Labiano I., Andreu J. L. 1998; Role of the new azoles in the treatment of fungal osteoarticular infections. Semin Arthritis Rheum 27:226–244 [View Article][PubMed]
    [Google Scholar]
  9. Rachapalli S. M., Malaiya R., Mohd T. A., Hughes R. A. 2010; Successful treatment of Candida discitis with 5-flucytosine and fluconazole. Rheumatol Int 30:1543–1544 [View Article][PubMed]
    [Google Scholar]
  10. Swanson H., Hughes P. A., Messer S. A., Lepow M. L., Pfaller M. A. 1996; Candida albicans arthritis one year after successful treatment of fungemia in a healthy infant. J Pediatr 129:688–694 [View Article][PubMed]
    [Google Scholar]
  11. Thornton J., Rangaraj S. 2009; Disease modifying anti-rheumatic drugs in people with cystic fibrosis-related arthritis. Cochrane Database Syst Rev1CD007336[PubMed]
    [Google Scholar]
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