Keiser G, Schmid M, Ishak K G, Wirth W, Vogt M
Medizinische Klinik, Kantonsspital Zug.
Schweiz Med Wochenschr. 1996 Apr 27;126(17):713-7.
The spectrum of disseminated candidiasis includes both an acute and chronic presentation. In contrast to the acute form, chronic disseminated candidiasis (hepatosplenic candidiasis) often occurs late after granulocytopenic episodes in patients undergoing chemotherapy, usually for acute leukemia. We discuss a female patient who underwent extensive successful chemotherapy for acute myelogenous leukemia (FAB type 6) and who developed chronic hepatosplenic candidiasis 19 months later. Therapy with amphotericin B and flucytosine was not successful and a cure was effected only after long-term oral fluconazole treatment. Diagnostic problems, possible reasons for the observed failure of amphotericin B treatment, and the current use of fluconazole in disseminated candidiasis are discussed.
播散性念珠菌病的临床表现包括急性和慢性两种形式。与急性形式不同，慢性播散性念珠菌病（肝脾念珠菌病）通常发生在接受化疗（通常是针对急性白血病）的粒细胞减少症发作后期。我们讨论了一名女性患者，她接受了针对急性髓性白血病（FAB 6型）的广泛且成功的化疗，19个月后发生了慢性肝脾念珠菌病。两性霉素B和氟胞嘧啶治疗未成功，仅在长期口服氟康唑治疗后才治愈。文中讨论了诊断问题、两性霉素B治疗失败的可能原因以及氟康唑目前在播散性念珠菌病中的应用。
