Loeliger A, van Leeuwen M, Rozenberg-Arska M, Dekker A W
Dept. of Internal Medicine, University Hospital Utrecht, The Netherlands.
Infection. 1992 Nov-Dec;20(6):336-8.
We report on two patients with acute leukemia and prolonged granulocytopenia after cytotoxic therapy in whom the diagnosis hepatosplenic candidiasis was made. Both patients developed upper abdominal discomfort with elevated alkaline phosphatase after resolution of granulocytopenia. The diagnosis was established by demonstration of multiple abscesses in liver and spleen on ultrasound and computed tomography. Both patients were initially treated with amphotericin B i.v., one of them received liposomal amphotericin B (cumulative dose of 2,530 mg and 570 mg, respectively). Thereafter, therapy was continued for months with oral fluconazole. The treatment of hepatosplenic candidiasis was successful, however, the patients died from relapse and progression of leukemia.
我们报告了两名急性白血病患者，他们在接受细胞毒性治疗后出现粒细胞缺乏延长，最终被诊断为肝脾念珠菌病。两名患者在粒细胞缺乏症缓解后均出现上腹部不适，碱性磷酸酶升高。通过超声和计算机断层扫描显示肝脏和脾脏有多个脓肿，从而确诊。两名患者最初均接受静脉注射两性霉素B治疗，其中一名患者接受了脂质体两性霉素B（累积剂量分别为2530毫克和570毫克）。此后，口服氟康唑持续治疗数月。肝脾念珠菌病的治疗取得了成功，然而，患者最终死于白血病复发和进展。
