Weisse M E, Person D A, Berkenbaugh J T
Department of Pediatrics, Tripler Army Medical Center, Honolulu, Hawaii.
J Perinatol. 1993 Sep-Oct;13(5):402-4.
A premature infant with disseminated Candida tropicalis infection with arthritis and osteomyelitis is presented. Although the organism was susceptible to amphotericin B, synovial fluid cultures were still positive for yeast after 2 weeks of intravenous amphotericin B therapy. The addition of oral flucytosine (25 mg/kg four times daily) resulted in sterilization of the synovial fluid within 4 days. Simultaneous serum and synovial levels of flucytosine were 47.5 micrograms/ml and 39.6 micrograms/ml, respectively. This is the first documentation in the medical literature of intraarticular levels of flucytosine, and provides further rationale for the use of flucytosine in addition to amphotericin B in patients with Candida arthritis.
本文报告了一名患有播散性热带念珠菌感染并伴有关节炎和骨髓炎的早产儿。尽管该病原体对两性霉素B敏感，但在静脉注射两性霉素B治疗2周后，滑膜液培养的酵母仍呈阳性。加用口服氟胞嘧啶（每日4次，每次25mg/kg）后，滑膜液在4天内转为无菌。同时，血清和滑膜液中的氟胞嘧啶水平分别为47.5微克/毫升和39.6微克/毫升。这是医学文献中首次记录关节内氟胞嘧啶水平，为在念珠菌性关节炎患者中除使用两性霉素B外加用氟胞嘧啶提供了进一步的理论依据。
