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Hepatic Candidiasis in an Immunocompetent Patient: A Diagnostic Challenge
Zorays Moazzam1, Amman Yousaf2,3, Zahid Iqbal4
1Surgery, Aga Khan University Hospital, Karachi, PAK.
Insights
Hepatic candidiasis, a rare fungal infection of the liver, can occur in immunocompetent individuals. Early diagnosis and treatment with fluconazole are crucial for a good prognosis in these rare cases.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Hepatology
Background:
- Hepatic candidiasis is typically seen in immunocompromised patients.
- Focal hepatic candidiasis in immunocompetent individuals is exceptionally rare.
Observation:
- A case of an immunocompetent female presenting with respiratory distress and pleural effusion.
- Computed tomography (CT) scan revealed a subcapsular liver collection.
- CT-guided aspiration identified Candida albicans growth.
Findings:
- The patient was successfully treated with oral fluconazole.
- Follow-up CT confirmed the resolution of the hepatic collection.
Implications:
- Hepatic candidiasis should be considered in the differential diagnosis of liver abscesses, even in immunocompetent patients.
- Prompt diagnosis and management are essential for favorable outcomes.
Abstract:
Hepatic candidiasis is a manifestation of disseminated candidiasis, which typically presents in immunocompromised patients. Focal hepatic candidiasis in immunocompetent patients, however, is infrequent/extremely rare. We present the case of an immunocompetent female patient who presented with respiratory distress and right-sided pleural effusion. The pleural fluid tap did not grow anything, and a contrast-enhanced computed tomography (CT) scan revealed a right liver lobe subcapsular collection. CT-guided aspiration and culture resulted in Candida albicans growth. The patient responded to oral fluconazole, and a follow-up CT scan demonstrated resolution of the collection. Although hepatic candidiasis rarely occurs in immunocompetent patients, it should be included in the differential diagnosis of hepatic abscesses, as timely diagnosis and management are crucial in conferring a good prognosis.
