Abstract
Purpose: Hepatosplenic candidiasis is a well known complication of pa• tients treated with hlgh-dose chemotherapy. Febnle neutropenia is a major risk factor for the onset of systemic fungal infections. Early detection and long lasting antifungal therapy are important prognostic factors. There• fore evaluation of incidences and sonographic features in hepatosplenic candidiasis is required. Methods: PIs undergoing high-dose chemotherapy were examined by routine abdominal ultrasound scan. Whenever clinical signs of infection occurred, I.e. fever >38.5 ·C,the pis were reevaluated. Within a two-months period from Dec 96 to Jan 97, 90 consecutive pts were examined with a 3.5 MHzconvexphased-array (Kranzbuhler Logiq 500). Results: In 3 pts hepatic andlor splenic microabscesses were detected, 2 pts showed a typical in wheel sign, 1 pt had multiple dlcrete hypoechoic lesions in the liver and spleen. A changed structural pattern, showing inhomogeneity of liver and spleen, was documented in 2 further pts. which was highly suspicious for an evolving systemic hepatosplenic candidiasis. Conclusion: Ultrasound IS a sensitive and easily accessable method to detect microabscesses and other typical morphological changes allowing early detection of hepatosplenic candidiasis. The incidence in our pallent sample was 3.3%. Therefore we would recommend abdominal ultrasound screening for all patients with febrile neutropenia to improve antimycotic treatment strategies. Palliative treatment of accessible solid tumors with Intraturnoral cisplatinlepinephrlne Injectable gel
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