Related Experiment Videos
[Microabscesses of the spleen in patients with acute leukemia]
Abstract:
Eight patients with acute myelogenous leukemia in complete remission after induction chemotherapy developed septic fever. Fever was unresponsive to broad-spectrum antibiotic therapy. Ultrasonography showed multiple 0.5-2 cm in diameter, anechoic densities and some 1-3 cm "target" appearances in spleen and liver. Computed tomography demonstrated multiple, round, 0.5-2 cm areas of diminished attenuation in spleen and liver, which did not enhance like the surrounding parenchyma. These microabscesses increased in size and number without equivalent antifungal therapy and decreased or disappeared after specific treatment. Candida-infection was confirmed by histologically from liver specimens in four patients, fungal organisms were seen microscopically an liver-biopsy in one patient and at autopsy one patient was found to have candida disseminated to the spleen, liver, kidneys, lung and CNS.
Insights
Septic fever in acute myelogenous leukemia patients was linked to disseminated Candida infection. Early antifungal therapy is crucial for treating these fungal microabscesses in the liver and spleen.
Area of Science:
- Mycology
- Hematology
- Infectious Diseases
Context:
- Acute myelogenous leukemia (AML) patients in remission can develop opportunistic infections.
- Septic fever unresponsive to antibiotics suggests an alternative etiology.
Purpose:
- To investigate the cause of persistent septic fever in AML patients.
- To characterize the imaging findings and clinical course of disseminated fungal infection.
Summary:
- Eight AML patients in remission presented with persistent septic fever.
- Imaging revealed multiple hepatic and splenic microabscesses.
- Disseminated Candida infection was confirmed, with resolution following antifungal treatment.
Impact:
- Highlights the importance of considering fungal infections in febrile AML patients.
- Demonstrates the utility of imaging in diagnosing disseminated candidiasis.
- Emphasizes the need for prompt antifungal therapy to manage microabscesses.