Candidiasis of the liver and spleen in childhood

Four children with acute leukemia and surgically documented candidiasis of the liver and/or spleen were examined with a combination of diagnostic imaging modalities including 99mTc-sulfur colloid and 67Ga-citrate scintigraphy, gray-scale ultrasound, and body computed tomography (CT). Abnormalities were detected in every individual examined. 99mTc-sulfur colloid scintigraphy revealed "cold" areas in the liver or spleen. With 67Ga scintigraphy, these areas were "cold" in some individuals and "hot" in others. Gray-scale ultrasound demonstrated hypoechoic lesions with central areas of increased echogenicity in hepatic involvement, and hypoechoic replacement of the spleen in splenic involvement. CT in one patient revealed low-density areas without contrast enhancement within the hepatic parenchyma and unsuspected renal involvement.