MULTIFOCAL OSTEOARTHRITIS DUE TO CANDIDA-ALBICANS IN A NEONATE - SERUM LEVEL MONITORING OF LIPOSOMAL AMPHOTERICIN-B AND LITERATURE-REVIEW

A 32-week neonate weighing 2,300 g at birth with fungemia due to Candi da albicans subsequently developed multifocal osteoarthritis of the lo wer extremities due to the same organism during therapy with amphoteri cin B (0.5 mg/kg/day) and flucytosine (100 mg/kg/day) to which the iso lates were susceptible. Liposomal amphotericin B (3.5 mg/kg/day) was s ubstituted for conventional amphotericin B and complete clinical and r adiologic recovery as well as sterilization of affected joints were ac hieved with a 38-day-course (144.5 mg/kg total). Adequate drug concent rations in serum and synovial fluid were attained with liposomal ampho tericin B. Nine neonates (less than or equal to 28 days of age),vith b one and/or joint infections due to Candida spp. had previously been re ported in the English-language literature. To our knowledge, the prese nt case is the first reported cure with liposomal amphotericin B. Prev ious cases are reviewed and the potential role of liposomal amphoteric in B in this serious neonatal infection is discussed.