In our experience, hepatosplenic candidiasis HSC without documented candidemia often remains unrecognized. We describe three cases of HSC without documented candidemia and the challenges in establishing the diagnosis and adequately treating this condition. The first patient had a history of SCT for treatment of breast cancer and was scheduled for hemihepatectomy for suspected liver metastasis. A second opinion at our institute resulted in the diagnosis of hepatic candidiasis without prior documented candidemia, for which she was treated successfully with fluconazole.
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Both hepatic and splenic infection usually happens simultaneously, the reason why they are approached together. On imaging, it typically presents as multiple microabscesses scattered through the liver and splenic parenchyma. Usually, the presentation occurs in at-risk immunosuppressed patients, with fevers unresponsive to usual antibiotics. Candida species can invade the intestinal mucosa during periods of marked neutropenia and invade the liver through the portal circulation 2.
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URL of Article. Article information. System: Hepatobiliary. Synonyms or Alternate Spellings: Candidiasis of the liver Candidiasis of the spleen Splenic candidiasis Hepatic candidiasis. Support Radiopaedia and see fewer ads. Cases and figures. Case 1 Case 1. Case 2 Case 2. Loading more images Close Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys.
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Hepatosplenic Candidiasis Without Prior Documented Candidemia: An Underrecognized Diagnosis?
Both hepatic and splenic infection usually happens simultaneously, the reason why they are approached together. On imaging, it typically presents as multiple microabscesses scattered through the liver and splenic parenchyma. Usually, the presentation occurs in at-risk immunosuppressed patients, with fevers unresponsive to usual antibiotics. Candida species can invade the intestinal mucosa during periods of marked neutropenia and invade the liver through the portal circulation 2. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Updating… Please wait.
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Hepatosplenic Candidiasis
Within the four overlapping forms of invasive candidiasis , there is a distinct clinical picture that has been given a variety of names: Chronic Disseminated Candidiasis CDC , Hepatosplenic Candidiasis, Hepatic Candidiasis and Granulomatous Hepatitis. As proposed by Bodey, we will generally use the term hepatosplenic candidiasis [ ]. However, the other terms are equally valid. At least in theory, a separation should be made between this entity and liver involvement in cases of acute disseminated candidiasis [ ].