Hepatosplenic candidiasis is a distinct clinical variant of candidiasis in immunocompromised patients. It has become a major problem in the patients with acute leukemia, whose disease is in remission after successful induction chemotherapy.
Manifestations of disease at the time when hepatic involvement is documented are localized to the liver and/or spleen. Patients with focal hepatosplenic candidiasis have unresponisve to antimicrobial therapy, prominent gastrointestinsl symptoms
and
signs, elevated levels of alkaline phosphatase, and hepatosplenic defects noted on abdominal US or CT. Histopathologic demonstration of Candida organisms in tisue specimens is neccessary for a definite diagnosis. Cultures taken from involved
tissues are
often negative. Response to conventional therapy with amphotericin B is poor, and this form of candidiasis often persists after months of therapy.
We report three cases of hepatosplenic candidiasis in leukemic patients, and review clinical, laboratory, radiologic findings, and treatment of hepatosplenic candidiasis in the medical literatures.
|