Troussard X, Reman O, Galateau F, Duhamel C, Leporrier M
Service d'Hématologie clinique, Centre hospitalier universitaire, Caen.
Presse Med. 1989 Oct 21;18(34):1687-90.
In patients with acute leukaemia, Candida infection may affect exclusively the liver and the spleen. Two such cases were revealed by persistent fever despite correction of bone marrow aplasia, abdominal pain, anicteric cholestasis and hypodense areas at computerized tomography suggesting hepatosplenic abscesses. Surgical liver biopsy confirmed the fungal infection and showed images of granuloma, mycelial filaments and yeasts; cultures were usually negative. The severity of these infections requires an early treatment, but amphotericin B is not very effective. Our two patients were cured after treatment with fluoconazole completed, in one of them by splenectomy.
在急性白血病患者中，念珠菌感染可能仅累及肝脏和脾脏。尽管骨髓再生障碍已得到纠正，但仍持续发热、伴有腹痛、无黄疸性胆汁淤积以及计算机断层扫描显示肝脾有低密度区，由此发现了两例这样的病例，提示存在肝脾脓肿。手术肝活检证实了真菌感染，并显示出肉芽肿、菌丝和酵母的图像；培养结果通常为阴性。这些感染的严重性需要早期治疗，但两性霉素B效果不太理想。我们的两名患者在完成氟康唑治疗后治愈，其中一名患者通过脾切除术治愈。
