Clinical features and prognosis of hepatosplenic candidiasis in patients with hematopathy
10.3760/cma.j.cn121090-20231230-00347
- VernacularTitle:血液病患者合并肝脾念珠菌病的临床特征及预后
- Author:
Danping ZHU
1
;
Rui MA
;
Yun HE
;
Xueyi LUO
;
Wei HAN
;
Chuan LI
;
Jingrui ZHOU
;
Yi LIAO
;
Borui TANG
;
Longtong LONGKA
;
Xiaojun HUANG
;
Yuqian SUN
Author Information
1. 北京大学人民医院，北京大学血液病研究所，国家血液系统疾病临床医学研究中心，造血干细胞移植治疗血液病北京市重点实验室，北京 100044
- From:
Chinese Journal of Hematology
2024;45(7):683-688
- CountryChina
- Language:Chinese
-
Abstract:
Hepatosplenic candidiasis (HSC) is a rare type of candidiasis that can occur in patients with hematologic malignancies, hematopoietic stem cell transplantation. At present, there is still a lack of studies on HSC in patients with hematologic disorders. Based on The Chinese Guidelines for the Diagnosis and Treatment of Invasive Fungal Disease in Patients with Hematological Disorders and Cancers (the 6th revision), We retrospectively analyzed the clinical characteristics and prognosis of patients with HSC treated in Peking University Institute of Hematology from 2008 to 2022. Finally, eighteen patients were included, with 1 (5.6%) proven, 2 (11.1%) probable, and 15 (83.3%) possible HSC. Among them, 3 (16.7%) patients occurred after haploid hematopoietic stem cell transplantation and 15 (83.3%) patients occurred after chemotherapy. 6 (33.3%) patients had positive blood cultures, including 4 cases of Candida tropicalis and 2 cases of Candida albicans. At 4 weeks of antifungal therapy, 10 (58.8%) patients achieved partial response (PR), At 8 weeks, 1 (6.3%) patients achieved complete response and 10 (62.5%) patients achieved PR. At 6 months after diagnosis, 3 (16.7%) patients died of hematopoietic recurrence, and none of them died of HSC. As a rare fungal infection disease, HSC has a low positive rate of microbiological and histological examinations, a persistent treat cycle, and has difficulty in remission, reminding us of the need for vigilance in patients with hematopoietic disorders and persistent fever.
