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Hepatosplenic candidiasis, a fatal disease?
A Loeliger1, M van Leeuwen, M Rozenberg-Arska
1Dept. of Internal Medicine, University Hospital Utrecht, The Netherlands.
Infection
|November 1, 1992
Summary
This study details two acute leukemia patients with hepatosplenic candidiasis post-chemotherapy. While antifungal treatment was successful, both patients succumbed to their underlying leukemia.
Area of Science:
- Mycology
- Hematology
- Infectious Diseases
Background:
- Cytotoxic chemotherapy for acute leukemia can lead to prolonged granulocytopenia, increasing susceptibility to opportunistic fungal infections.
- Hepatosplenic candidiasis is a severe disseminated fungal infection that can occur in immunocompromised patients.
Observation:
- Two patients with acute leukemia presented with hepatosplenic candidiasis following cytotoxic therapy and granulocytopenia.
- Symptoms included upper abdominal discomfort and elevated alkaline phosphatase after granulocytopenia resolved.
- Imaging revealed multiple liver and spleen abscesses, confirming the diagnosis.
Findings:
- Antifungal therapy, including intravenous amphotericin B (liposomal formulation used in one case) followed by oral fluconazole, successfully treated the hepatosplenic candidiasis.
- Despite successful fungal infection management, both patients ultimately died due to relapse and progression of their acute leukemia.
Implications:
- Hepatosplenic candidiasis is a serious complication in acute leukemia patients undergoing cytotoxic therapy.
- Prompt diagnosis and aggressive antifungal treatment are crucial for managing this infection.
- The underlying hematological malignancy remains a significant factor in patient outcomes, even with successful treatment of secondary infections.