[Fungal arthritis--a rare complication of systemic candidiasis or orthopedic intervention. Review of therapeutic experience with fluconazole].

The higher number of implanted artificial joints, the broader use of aggressive treatment regimen, e.g. high-dose chemotherapy and total parenteral nutrition, the increasing use of central venous catheters and a broader use of immunosuppressive drugs are likely to result in a higher incidence of fungal arthritis, especially caused by Candida spp. Therefore, a careful evaluation of the available therapeutic options is necessary. The published clinical data on the therapeutic use of fluconazole in the treatment of fungal arthritis were reviewed. A total of 24 publications report the use of fluconazole in fungal arthritis in 32 patients. The mean duration of therapy was 6 months (maximum duration: 2 years) with an average dosage of 200-400 mg/d (maximum dosage: 800 mg/d). Native arthritis was diagnosed in 27 patients, prosthetic arthritis in 5 patients. In all patients an isolated joint was infected, most frequently the knee joint. Fluconazole was effective and safe in acute therapy alone or in combination with surgery as well as in long term suppression therapy.