Author/Authors :
Ozturk, E K Ege University - Faculty of Medicine - Department of Internal Diseases, Turkey , Soyer, N Ege Üniversitesi - Tıp Fakültesi - Hematoloji Bilim Dalı, Turkey , Bayraktaroglu, S Ege University - Faculty of Medicine - Department of Radiology, Turkey , Hekimgil, M Ege University - Faculty of Medicine - Department of Pathology, Turkey , Tobu, M Ege University - Faculty of Medicine - Department of Hematology, Turkey , Arda, B Ege University - Faculty of Medicine - Department of Infection Diseases, Turkey
Abstract :
Chronic disseminated candidiasis (CDC) is a type of systemic disseminated candida infection and affects neutropenic patients. In this case report, a patient with acute myeloid leukemia (AML) who was diagnosed with CDC during remission induction chemotherapy and treated with amphotericin B and fluconazole respectively is reported. After chemotherapy, a fever that was unresponsive to broad spectrum antibiotic treatment occurred in the patient. Liposomal amphotericin B (lip-amp-B) treatment was started. Serum galactomannan (GM) screening and blood cultures were negative. High resolution computed tomography (CT) was normal. Lip-amp-B treatment was stopped after an afebrile, non-neutropenic period was documented. After all treatment was stopped, the patient became febrile again and abdominal pain occurred. The serum alkaline phosphatase (ALP) level was increased. Blood cultures and GM test were negative and an abdominal CT showed multiple nodular lesions in the spleen. CDC was considered. The patient was treated successfully with amphotericin B. This should be kept in mind in cases of CDC in AML patients who were treated with chemotherapy especially if the fever cannot be controlled although broad spectrum antibiotics
