Hepatosplenic Candidiasis Detected by 18F-FDG-PET/CT

Document Type: Case report

Authors

1 Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy.

2 Department of Molecular and Translational Medicine, Anatomic Pathology Section, Spedali Civili Brescia, Brescia, Italy

Abstract

Hepatosplenic candidiasis is a fungal infection, which mostly affects patients
with hematologic malignancies such as leukemia. The pathogenesis of this
infection is not clear yet, and the liver is the most commonly affected organ.
Diagnosis of hepatosplenic candidiasis can be only established via biopsy,
since computed tomography (CT) scan, ultrasonography, and magnetic
resonance imaging (MRI) yield non-specific results. The role of fluorine-18
fluorodeoxyglucose positron emission tomography /computed tomography
(18F-FDG PET/CT) in diagnosis of hepatosplenic candidiasis remains
undetermined, considering a few evidences in the literature. In this case
report, we present the case of a 47-year-old patient, affected by acute myeloid
leukemia, which was treated with three cycles of chemotherapy, resulting in
the development of neutropenia and fever following the last cycle. The 18F-FDG
PET/CT scan showed some foci of intense FDG uptake in the liver and spleen.
The subsequent diagnostic investigations (i.e., abdominal CT scan and biopsy)
were suggestive of hepatosplenic candidiasis. The patient was started on
antifungal treatment with fluconazole. After one month, the clinical conditions
were resolved, and the subsequent abdominal CT scan was negative.

Keywords

Main Subjects


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