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Nosocomial Fungemia in a Normal Host

Donald R. Graham, MD
JAMA. 1983;250(20):2791. doi:10.1001/jama.1983.03340200025016.
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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


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