Fluconazole in the Treatment of Hepatosplenic Candidiasis

Michael T. Flannery, David B. Simmons, Hussain Saba, Philip Altus, Paul M Wallach, Harold M. Adelman

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Hepatosplenic candidiasis has increased in frequency among immunocompromised hosts. Risk factors include hematologic malignancy, intensive chemotherapy, prolonged neutropenia, and treatment with broad-spectrum antibiotics. Patients most commonly present with abdominal pain, persistent fevers despite antibiotic therapy, and an elevated alkaline phosphatase level that is out of proportion to other hepatic enzyme levels. Gastrointestinal mucosal damage secondary to intensive chemotherapy may allow colonization with Candida species and subsequent seeding of the portal vein. Treatment has consisted of prolonged courses of amphotericin B, with mortality rates approaching 50%. We report a case of hepatosplenic candidiasis in a patient with acute myelogenous leukemia who had clinical and radiographic improvement during fluconazole therapy. Fluconazole may be an efficacious and less toxic alternative to amphotericin B.

Original languageEnglish (US)
Pages (from-to)406-408
Number of pages3
JournalArchives of Internal Medicine
Volume152
Issue number2
DOIs
StatePublished - Jan 1 1992

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Fluconazole
Candidiasis
Amphotericin B
Anti-Bacterial Agents
Drug Therapy
Poisons
Immunocompromised Host
Hematologic Neoplasms
Therapeutics
Portal Vein
Neutropenia
Candida
Acute Myeloid Leukemia
Abdominal Pain
Alkaline Phosphatase
Fever
Mortality
Liver
Enzymes

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Flannery, M. T., Simmons, D. B., Saba, H., Altus, P., Wallach, P. M., & Adelman, H. M. (1992). Fluconazole in the Treatment of Hepatosplenic Candidiasis. Archives of Internal Medicine, 152(2), 406-408. https://doi.org/10.1001/archinte.1992.00400140142030

Fluconazole in the Treatment of Hepatosplenic Candidiasis. / Flannery, Michael T.; Simmons, David B.; Saba, Hussain; Altus, Philip; Wallach, Paul M; Adelman, Harold M.

In: Archives of Internal Medicine, Vol. 152, No. 2, 01.01.1992, p. 406-408.

Research output: Contribution to journalArticle

Flannery, MT, Simmons, DB, Saba, H, Altus, P, Wallach, PM & Adelman, HM 1992, 'Fluconazole in the Treatment of Hepatosplenic Candidiasis', Archives of Internal Medicine, vol. 152, no. 2, pp. 406-408. https://doi.org/10.1001/archinte.1992.00400140142030
Flannery MT, Simmons DB, Saba H, Altus P, Wallach PM, Adelman HM. Fluconazole in the Treatment of Hepatosplenic Candidiasis. Archives of Internal Medicine. 1992 Jan 1;152(2):406-408. https://doi.org/10.1001/archinte.1992.00400140142030
Flannery, Michael T. ; Simmons, David B. ; Saba, Hussain ; Altus, Philip ; Wallach, Paul M ; Adelman, Harold M. / Fluconazole in the Treatment of Hepatosplenic Candidiasis. In: Archives of Internal Medicine. 1992 ; Vol. 152, No. 2. pp. 406-408.
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