Ketoconazole in the treatment of osteomyelitis due to Candida albicans.

Osteomyelitis caused by Candida albicans is a rare condition. The authors report its occurrence as an infective complication in the fractured phalanx of a 3-year-old boy. The infection was first thought to be due to Staphylococcus aureus, but a course of cloxacillin was unsuccessful, and when cultures of the injured finger grew C. albicans, a 3-month course of ketoconazole orally was begun. Ketoconazole was prescribed because, unlike amphotericin B, the antibiotic usually used in such cases, it is not nephrotoxic, it can be taken orally and it has proved successful in other reported cases of osteomyelitis due to C. albicans. The boy's infection resolved and fracture healing was confirmed radiologically.