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[Hepatosplenic candidiasis in acute non-lymphocytic leukemia].

Authors
  • Miyazaki, S
  • Miura, A B
Type
Published Article
Journal
Kansenshōgaku zasshi. The Journal of the Japanese Association for Infectious Diseases
Publication Date
Jul 01, 1991
Volume
65
Issue
7
Pages
794–798
Identifiers
PMID: 1919111
Source
Medline
License
Unknown

Abstract

Eleven patients with acute non-lymphocytic leukemia developed hepatosplenic candidiasis following the termination of chemotherapy. Five who did not receive amphoteicin B (AMPH) died of liver failure, whereas the other six who received AMPH and/or miconazole or fluconazole were cured. The features of hepatosplenic candidiasis included prolonged high fever not responsive to antibiotics and hepatomegaly with right-sided hypochondrial pain developing after severe neutropenia. Even if the neutropenia recovered, these symptoms did not subside. In addition, elevation of the serum alkaline phosphatase and total bilirubin levels were observed at onset. CT scan revealed multiple low-density areas of varying size that showed no contrast enhancement. Ultrasonography also demonstrated hypoechoic or hyperechoic lesions, and a so-called "target sign appearance" in the liver and spleen. The clinical diagnosis for hepatosplenic candidiasis is not so difficult because of the uniform symptoms, signs and laboratory abnormalities. The importance of the early administration of antifungal agents to obtain a cure is discussed in this article.

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