Diagnosis and Outcome of Disseminated Candidiasis
| Patient . | Age, Sex, Disease . | CT Scan Dx* . | Smear . | Histology . | No. of Cycles† Before Dx . | No. of Cycles† After Dx . | Treatment and Outcomeρ of Disseminated Candidiasis . |
|---|---|---|---|---|---|---|---|
| A | 42, F, AML | Liver | Neg (3×) | Neg | 1 | 21-155 | Ampho 107 d, Fluc 7 d, Ampho 101 d, Fluc 225 d; no recurrence thereafter for 34+ mo |
| Spleen | — | — | |||||
| B | 18, F, ALL | Liver | Pos | ND | 2 | 1 | Ampho 11 d, Fluc 58 d, Ampho 21 d, Fluc 121 d; no recurrence thereafter for 31+ mo |
| C | 41, F, ALL | Liver | Pos | Consistent | 2 | 1 | Ampho 41 d, Fluc 147 d; no recurrence thereafter for 7 mo |
| Spleen | — | — | |||||
| D | 47, F, AML | Liver | Neg | Consistent | 2 | 2 | Ampho 23 d, Fluc 17 d, Ampho 28 d, Fluc 102 d; no recurrence thereafter for 17+ mo |
| E | 26, M, AML | Liver | Neg | Pos | 1 | 2¶ | Ampho 22 d, Fluc 363 d; no recurrence thereafter for 10+ mo |
| Spleen | — | — |
| Patient . | Age, Sex, Disease . | CT Scan Dx* . | Smear . | Histology . | No. of Cycles† Before Dx . | No. of Cycles† After Dx . | Treatment and Outcomeρ of Disseminated Candidiasis . |
|---|---|---|---|---|---|---|---|
| A | 42, F, AML | Liver | Neg (3×) | Neg | 1 | 21-155 | Ampho 107 d, Fluc 7 d, Ampho 101 d, Fluc 225 d; no recurrence thereafter for 34+ mo |
| Spleen | — | — | |||||
| B | 18, F, ALL | Liver | Pos | ND | 2 | 1 | Ampho 11 d, Fluc 58 d, Ampho 21 d, Fluc 121 d; no recurrence thereafter for 31+ mo |
| C | 41, F, ALL | Liver | Pos | Consistent | 2 | 1 | Ampho 41 d, Fluc 147 d; no recurrence thereafter for 7 mo |
| Spleen | — | — | |||||
| D | 47, F, AML | Liver | Neg | Consistent | 2 | 2 | Ampho 23 d, Fluc 17 d, Ampho 28 d, Fluc 102 d; no recurrence thereafter for 17+ mo |
| E | 26, M, AML | Liver | Neg | Pos | 1 | 2¶ | Ampho 22 d, Fluc 363 d; no recurrence thereafter for 10+ mo |
| Spleen | — | — |
Abbreviations: Dx, diagnosis; F, female; M, male; Neg, negative; Pos, positive; ND, not determined; Ampho, amphotericin B; Fluc, fluconazole.
Diagnosis of disseminated candidiasis was based on clinical, laboratory, radiologic, pathologic, and microbiologic findings (see text).
Number of chemotherapy cycles with prolonged neutropenia before and after the diagnosis of hepatic candidiasis is listed.
ρ Treatment duration in days is listed chronologically for amphotericin B and fluconazole (see text).
In addition to their 2 cycles of chemotherapy, both patients A and E later underwent alloBMT (see text).