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Liposomal amphotericin B in hepatic candidosis
M Sharland1, R J Hay, E G Davies
1Department of Child Health, St George's Hospital Medical School, London.
Archives of Disease in Childhood
|June 1, 1994
Summary
A young girl with acute lymphoblastic leukemia developed a serious fungal infection, hepatic candidosis. Liposomal amphotericin effectively treated the infection, preventing relapse for a year.
Area of Science:
- Pediatric Oncology
- Mycology
- Infectious Diseases
Background:
- Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
- Chemotherapy for ALL can lead to significant immunosuppression.
- Fungal infections, such as hepatic candidosis, are serious complications in immunocompromised patients.
Observation:
- A 4-year-old girl with ALL developed hepatic candidosis during chemotherapy.
- Initial treatment with amphotericin B and flucytosine failed to resolve the infection.
- The patient experienced a relapse after initial treatment.
Findings:
- An eight-week course of liposomal amphotericin resulted in marked clinical improvement.
- The patient remained stable for one year following liposomal amphotericin treatment.
- A subsequent relapse of the fungal infection was noted.
Implications:
- Liposomal amphotericin is a potential therapeutic option for refractory hepatic candidosis in pediatric leukemia patients.
- Early recognition and aggressive treatment of fungal infections are crucial in immunocompromised children.
- Transformation to myelodysplastic leukemia occurred after the relapse, highlighting complex disease progression.