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Case Study Chronic Disseminated Candidiasis stormy course requiring 4 additional weeks of anti-fungal therapy. Eventually the patient's liver enzymes returned to normal and follow-up abdominal computed tomography showed resolution of hepatic and splenic abscesses. He was discharged home after a 2- month hospitalization. What happened?

Answer: Chronic disseminated candidiasis (he-patosplenic candidiasis) occurs in patients with profound neutropenia. This patient was appropriately treated for possible fungal sepsis when antibacterial therapy failed to resolve fever in the setting of neu-tropenia. Despite therapy, however, the patient did have disseminated candidiasis, which persisted in a subclinical state during the long period of neutrope-

nia. Once neutropenia resolved and the patient could generate an inflammatory response, fever reappeared and the patient worsened clinically. A new elevation in serum transaminases provided the clue that led to abdominal imaging and the detection of abscesses in the liver and spleen. The diagnosis of chronic disseminated candidiasis is often not confirmed by blood culture; the yield of blood cultures in the detection of candidemia is poor, with up to 50% of blood cultures falsely negative in this setting. Chronic disseminated candidiasis in neu-tropenic leukemia patients is a life-threatening infection with significant morbidity and mortality.

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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