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International Journal of Hematology

, Volume 79, Issue 3, pp 289–292 | Cite as

Successful Treatment of Chronic Disseminated Candidiasis with Caspofungin and Itraconazole in a Patient with Progressive Acute Leukemia and Prolonged Neutropenia

  • K. Hübel
  • J. Chemnitz
  • H. -G. Brochhagen
  • O. A. Cornely
Case Report

Abstract

Severe fungal infections remain a significant cause of morbidity and mortality in neutropenic patients undergoing doseintensive chemotherapy for malignant diseases. Chronic disseminated candidiasis (CDC) is a life-threatening complication in neutropenic patients because of the lack of responsive hematopoietic precursor cells. Resolution of Candida organ lesions after hematopoietic reconstitution may take months. Here, we report the case of a 19-year-old neutropenic woman with relapsed acute myelogenous leukemia and candidiasis of liver, spleen, and kidneys. Antifungal treatment was initiated using fluconazole and caspofungin but was changed to itraconazole and caspofungin. Despite elevated C-reactive protein (CRP) levels and detectable Candida organ lesions, antileukemic therapy was restarted with interleukin 2 at the same time as antimicrobial treatment. Eight weeks after the start of interleukin therapy, CRP levels and organ lesions were decreased significantly irrespective of continuing neutropenia. This case report describes the successful treatment of CDC during neutropenia using combination antifungal therapy and suggests controlled studies to establish optimal therapeutic strategies.

Key words

Chronic disseminated candidiasis Neutropenia Therapy Progressive leukemia 

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Copyright information

© The Japanese Society of Hematology 2004

Authors and Affiliations

  • K. Hübel
    • 1
  • J. Chemnitz
    • 1
  • H. -G. Brochhagen
    • 2
  • O. A. Cornely
    • 1
  1. 1.Klinik I für Innere MedizinKlinikum der Universität zu KölnKölnGermany
  2. 2.Institut und Poliklinik für Radiologische Diagnostik der Universität zu KölnKölnGermany

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