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

Abstract

Hepatosplenic candidiasis is a fungal infection, which mostly affects patientswith hematologic malignancies such as leukemia. The pathogenesis of thisinfection 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 magneticresonance imaging (MRI) yield non-specific results. The role of fluorine-18fluorodeoxyglucose positron emission tomography /computed tomography(18F-FDG PET/CT) in diagnosis of hepatosplenic candidiasis remainsundetermined, considering a few evidences in the literature. In this casereport, we present the case of a 47-year-old patient, affected by acute myeloidleukemia, which was treated with three cycles of chemotherapy, resulting inthe development of neutropenia and fever following the last cycle. The 18F-FDGPET/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 onantifungal treatment with fluconazole. After one month, the clinical conditionswere resolved, and the subsequent abdominal CT scan was negative.

Keywords

• 18F-FDG
• PET/CT
• hepatosplenic candidiasis
• chronic disseminated candidiasis