To the Editor.—
Fungemias are occasional complications of diseases of immunosuppression. Disseminated histoplasmosis, blastomycosis, and coccidioidomycosis are known to occur in otherwise normal hosts, and recently D'Silva et al reported a case of disseminated aspergillosis in a presumably immunocompetent host (1982;248:1495). However, nosocomial fungemia is thought to relate to immune disorders.1 This report describes an apparently healthy patient in whom Candida tropicalis fungemia developed.
Report of a Case.—
A 56-year-old man with mild cerebral palsy fell on Feb 3, 1982, and sustained a comminuted fracture of the right hip. The hip was fixed internally with a Zimmer key-free screw and plate. The wound drained for two weeks and closed secondarily. Pain continued in the hip for the next five months, but the patient remained afebrile. A roentgenogram on July 20 indicated migration of the prosthesis, so it was removed; culture of the purulent bone yielded Staphylococcus aureus. He was