The occurrence of hepatosplenic candidiasis following prolonged neutropenic periods has emerged as a major problem for patients with leukemia. In order to evaluate the diagnostic value of various available procedures, we analyzed our findings regarding 26 leukemic patients with hepatosplenic candidiasis. A significantly increased level (> 50 mg/L) of serum C-reactive protein (S-CRP) was significantly more common than a daily fever (for which the mean temperature peak was > 37.5 degrees C) or raised levels of liver enzymes (serum alanine transferase, aspartate transferase, or alkaline phosphatase). Focal changes in the liver, spleen, or kidneys were detected in > 90% of the patients examined by computed tomography (CT) but in < 50% of those examined by ultrasonography. Seventeen diagnoses were based on the findings from microscopy of samples obtained invasively, whereas a positive fungal culture was the basis of the diagnosis for only five patients. In conclusion, monitoring the S-CRP level after a patient's recovery from neutropenia is useful in that its elevation is cause for early suspicion of hepatosplenic candidiasis. In detection of the hepatosplenic foci, CT is superior to ultrasonography. For establishing the specific diagnosis, aggressive collection of samples for microscopy is essential.
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http://dx.doi.org/10.1093/clinids/18.6.979 | DOI Listing |
Hepatosplenic candidiasis (HSC) is a rare type of candidiasis that can occur in patients with hematologic malignancies, hematopoietic stem cell transplantation. At present, there is still a lack of studies on HSC in patients with hematologic disorders. Based on The Chinese Guidelines for the Diagnosis and Treatment of Invasive Fungal Disease in Patients with Hematological Disorders and Cancers (the 6th revision), We retrospectively analyzed the clinical characteristics and prognosis of patients with HSC treated in Peking University Institute of Hematology from 2008 to 2022.
View Article and Find Full Text PDFBMC Infect Dis
March 2024
Infectious Disease Division, Moffitt Cancer Center, 12902 USF Magnolia Drive, 33612, Tampa, FL, USA.
Chronic disseminated candidiasis (CDC) is a severe but rarely seen fungal infection presenting in patients with hematologic malignancies after a prolonged duration of neutropenia. A high index of suspicion is required to diagnose CDC as standard culture workup is often negative. While tissue biopsy is the gold standard of diagnosis, it is frequently avoided in patients with profound cytopenias and increased bleeding risks.
View Article and Find Full Text PDFCureus
August 2023
Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, PSE.
Chronic disseminated candidiasis (CDC) is a severe form of disseminated fungal infection that commonly affects the liver, spleen, and kidneys. In rare cases, CDC can be further complicated by an excessive immune response known as immune reconstitution inflammatory syndrome (IRIS). This syndrome occurs during the phase of immune recovery and is characterized by a systemic inflammatory response and excessive release of cytokines.
View Article and Find Full Text PDFKey Clinical Message: Muscular and subcutaneous candidiasis is a rare entity in immunocompromised patients, but it should be kept in mind when we see multiple cystic soft tissue masses in addition to target-shaped hepatosplenic lesions in neutropenic patients. US and MRI are useful imaging modalities for the diagnosis and follow-up of these patients.
Abstract: Soft tissue candidiasis is an opportunistic infection in immunocompromised patients and must always be diagnosed and treated as soon as possible.
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