Hepatosplenic candidosis--a late manifestation of Candida septicemia.

Hepatolienal candidosis was diagnosed in 27 patients suffering from malignant hematologic disorders. All patients had received intensive cytostatic chemotherapy and developed septic, antibiotic-resistant temperatures during severe treatment-induced neutropenia. During neutropenia hepatic and splenic foci were not identified by imaging procedures. Foci were poorly defined histologically. Blastospores and pseudomycelia were seen in non-reactive tissue and within necrotic areas in the liver, spleen, and other organs. Only Candida species could be isolated. One to four weeks after granulocyte recovery, round liver and splenic foci were demonstrated by sonographic and CT scans. Histologically, there were necrotic areas with blastospores and pseudohyphae exhibiting different degrees of cellular border reaction. Whereas the maximum diameter of fungal foci in aplasia was 0.4 cm, these increased in size to 1.5 cm after granulocyte regeneration.