Abstract
Hepatosplenic candidiasis following granulocytopenic periods is a relatively recently recognised problem in immunocompromised patients, particularly in those with acute leukaemia. We present three patients in whom diagnosis of hepatosplenic candidiasis was suspected on the basis of ultrasonographic (US), computed tomographic (CT) findings and confirmed by laparoscopy and biopsy of liver lesions. All three patients were successfully treated briefly with amphotericin B, followed by a longer period of fluconazole. In one patient laparotomy and surgical evacuation of abscesses was performed. This condition could be more often recognised by careful follow-up of liver function test, C-reactive protein level, ultrasonography, CT and MRI after recovery from chemotherapy-induced neutropenia.
MeSH terms
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Adult
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Amphotericin B / therapeutic use
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Antifungal Agents / therapeutic use
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Candidiasis / complications
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Candidiasis / diagnosis*
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Candidiasis / drug therapy
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Female
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Fluconazole / therapeutic use
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Humans
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Leukemia, Monocytic, Acute / complications
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Leukemia, Monocytic, Acute / drug therapy
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Leukemia, Monocytic, Acute / immunology*
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Leukemia, Myeloid, Acute / complications
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Leukemia, Myeloid, Acute / drug therapy
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Leukemia, Myeloid, Acute / immunology*
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Leukemia-Lymphoma, Adult T-Cell / complications
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Leukemia-Lymphoma, Adult T-Cell / drug therapy
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Leukemia-Lymphoma, Adult T-Cell / immunology*
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Liver Diseases / complications
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Liver Diseases / diagnosis*
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Liver Diseases / drug therapy
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Male
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Middle Aged
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Neutropenia / chemically induced
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Neutropenia / immunology
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Opportunistic Infections / complications
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Opportunistic Infections / diagnosis*
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Opportunistic Infections / drug therapy
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Splenic Diseases / complications
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Splenic Diseases / diagnosis*
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Splenic Diseases / drug therapy
Substances
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Antifungal Agents
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Amphotericin B
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Fluconazole