A radiologic syndrome after high dose chemotherapy and autologous bone marrow transplantation, with clinical and pathologic features of systemic candidiasis.
BACKGROUND
The use of high dose chemotherapy in the treatment of solid tumors is associated with prolonged neutropenia and, consequently, in some patients, systemic candidiasis. The authors describe their experience with a clinicoradiologic syndrome developing after high dose chemotherapy was administered to patients with breast cancer.


METHODS
The authors evaluated the clinical and radiologic records of 12 patients in whom hepatic, splenic, or renal candidiasis developed.


RESULTS
Three patients had positive blood cultures for candida tropicalis. One of these patients and two others had fungal organisms identified with special stains of an organ aspirate. Most patients were asymptomatic, and most of them were treated successfully with antifungal agents, although untreated patients also recovered. There were no fatalities due to the candidiasis.


CONCLUSIONS
A radiographic syndrome resembling hepatic, splenic, or renal candidiasis is described, which occurred after high dose chemotherapy was administered and autologous bone marrow transplantation was performed on patients with breast cancer. This syndrome has a favorable prognosis. Conclusions as to the more indolent nature of this syndrome cannot be made; however, this topic warrants further investigation.
Mudad
R
R
Bone Marrow Transplant Program, Duke University Medical Center, Durham, North Carolina 27710.
Vredenburgh
J
J
Paulson
E K
EK
Ross
M
M
Meisenberg
B
B
Hussein
A
A
Peters
W P
WP
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D016465:Bone Marrow Purging; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D002177:Candidiasis / Q000000981:diagnostic imaging; D003131:Combined Modality Therapy; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D016469:Fungemia / Q000382:microbiology; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology*; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology*; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology; D012189:Retrospective Studies; D013158:Splenic Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology*; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous
D016179:Granulocyte Colony-Stimulating Factor; D000666:Amphotericin B; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D015725:Fluconazole