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Related Experiment Videos

Hepatosplenic candidiasis: wheels within wheels.

B Pastakia1, T H Shawker, M Thaler

  • 1Department of Diagnostic Radiology, Clinical Center, Bethesda, Md. 20892.

Radiology
|February 1, 1988
PubMed
Summary

Imaging for hepatic and splenic candidiasis in immunocompromised patients requires both ultrasound (US) and computed tomography (CT) for optimal detection. Even with negative scans, clinical suspicion warrants biopsy.

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Area of Science:

  • Medical Imaging
  • Radiology
  • Infectious Diseases

Background:

  • Candidiasis, a fungal infection, poses a significant risk to immunocompromised cancer patients.
  • Accurate and timely diagnosis of hepatic and splenic candidiasis is crucial for effective treatment.

Purpose of the Study:

  • To evaluate the effectiveness of serial abdominal ultrasound (US) and computed tomography (CT) in diagnosing hepatic and splenic candidiasis.
  • To identify characteristic imaging patterns associated with candidiasis in immunocompromised patients.

Main Methods:

  • Eight immunocompromised cancer patients with confirmed candidiasis underwent serial abdominal US and CT scans.
  • Imaging findings were analyzed for patterns of hepatic and splenic involvement.
  • Comparison of US and CT (nonenhanced and enhanced) detection capabilities was performed.

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Main Results:

  • Four distinct patterns of hepatic and splenic candidiasis were identified on US, including a "wheels-within-wheels" pattern.
  • Nonenhanced CT revealed periportal linear areas of increased attenuation, potentially calcified.
  • Some abscesses were better visualized with contrast enhancement, while others were seen on nonenhanced scans.
  • US and CT demonstrated complementary detection of lesions, with some lesions visible on one modality but not the other.
  • Pathological confirmation of candidiasis occurred in two cases despite normal imaging studies.

Conclusions:

  • A combination of US and both nonenhanced and enhanced CT provides maximum sensitivity for detecting hepatic and splenic candidiasis.
  • Even with negative imaging results, a strong clinical suspicion for candidiasis necessitates open biopsy for definitive diagnosis.