Apparent ketoconazole failure in candidal cholecystitis.

Fungal acalculous cholecystitis is a rarely recognized complication of disseminated candidal infections. We report such a case of systemic candidiasis that developed in a man who was diabetic while he was receiving broad-spectrum antibiotic therapy for an infected foot ulcer. Ketoconazole, a new imidazole antifungal agent, was used successfully to treat the systemic candidal infection but it failed to eradicate the fungus in the biliary tract.