Linker C A, DeGregorio M W, Ries C A
Med Pediatr Oncol. 1984;12(6):380-5. doi: 10.1002/mpo.2950120605.
Seven patients with acute leukemia and systemic candidiasis presented with a clinical syndrome of fever, abdominal pain, organomegaly, and a cholestatic pattern of hepatic dysfunction with an elevated alkaline phosphatase and normal transaminases. The abdominal CT scan demonstrated diffuse hepatic and splenic abscesses in all seven patients. Culture and histology of liver biopsy specimens was nondiagnostic in four of five cases. The CT-directed percutaneous needle aspirations of these lesions yielded diagnostic material in two of three cases. Culture-negative visceral abscesses in persistently febrile patients with acute leukemia should be recognized as being due to candidiasis. The abdominal CT scan may be useful in identifying this clinical-radiographic syndrome and in facilitating rapid diagnosis. Promptly administered antifungal therapy may lead to successful eradication of this infection.
7例急性白血病合并系统性念珠菌病患者出现发热、腹痛、器官肿大的临床综合征，肝功能呈胆汁淤积型，碱性磷酸酶升高而转氨酶正常。腹部CT扫描显示所有7例患者均有弥漫性肝脾脓肿。5例患者中有4例肝活检标本的培养和组织学检查未得出诊断结果。对这些病变进行CT引导下经皮针吸活检，3例中有2例获得了诊断性材料。急性白血病持续发热患者中培养阴性的内脏脓肿应被认定为念珠菌病所致。腹部CT扫描可能有助于识别这种临床影像学综合征并促进快速诊断。及时给予抗真菌治疗可能会成功根除这种感染。
