Levine M, Bader-Meunier B, Tassin E, Dupont B, Courtecuisse V, Tchernia G
Le Kremlin Bicêtre, Service des Adolescents, Hôpital de Bicêtre.
Arch Fr Pediatr. 1990 May;47(5):365-7.
The authors report two cases of splenic and hepatosplenic candidiasis occurring during a protracted neutropenia induced by chemotherapy for acute leukemia (lymphoblastic and myeloblastic respectively). Fungal infection was revealed by persistent or recurrent fever after correction of neutropenia. Diagnosis was suggested by findings at abdominal ultrasonography. It was confirmed by histological analysis which, in the first case, required open liver biopsy. In both cases, lack of improvement of splenic lesions despite treatment with Amphotericin B followed by fluconazole led to splenectomy. Both patients received postoperative anti fungal therapy with Ampho B and at one year's follow up, the patient who had the hepatosplenic candidiasis seems to have recovered.
作者报告了两例脾念珠菌病和肝脾念珠菌病病例，分别发生在急性白血病（淋巴细胞性和粒细胞性）化疗引起的长期中性粒细胞减少期间。中性粒细胞减少纠正后持续或反复发热提示真菌感染。腹部超声检查结果提示诊断。在第一例中，经组织学分析确诊，这需要进行开放性肝活检。两例患者尽管先用两性霉素B治疗，后用氟康唑治疗，但脾病变均无改善，最终均行脾切除术。两名患者术后均接受两性霉素B抗真菌治疗，在一年的随访中，患有肝脾念珠菌病的患者似乎已康复。
