title: The usefulness of the Platelia Candida antigen in a patient with acute lymphocytic leukemia and chronic disseminated candidiasis.
abstract: We report a protracted course of disseminated candidiasis due to Candida tropicalis in a 17-year-old man with acute lymphocytic leukemia. Despite adequate antifungal therapy (amphotericin B), C. tropicalis was recovered from biopsy specimens 25 days (skin) and 109 days (kidney) after the first positive blood cultures. While blood cultures became negative for C. tropicalis 11 days after the initiation of treatment, mannanemia persisted and became negative only after 130 days of antifungal therapy. Thus, antigen assays provided indicators of antifungal response. Differential diagnosis was difficult for this patient with the observation of persistent lesions in image studies. With positive results of antigen assays, an invasive procedure might be avoided and preemptive antifungal treatment could be initiated in a timely manner. Anti-mannan antibody remained undetectable up to 164 days after first positive blood culture despite the patient's recovery from neutropenia and recruitment of neutrophils in the tissue (skin).
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Hsin-Yun
authors.initials: HY
authors.lastname: Sun
authors.forename: Yu-Shin
authors.initials: YS
authors.lastname: Chiu
authors.forename: Jih-Luh
authors.initials: JL
authors.lastname: Tang
authors.forename: Jiun-Ling
authors.initials: JL
authors.lastname: Wang
authors.forename: Shan-Chwen
authors.initials: SC
authors.lastname: Chang
authors.forename: Yee-Chun
authors.initials: YC
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000908:Antibodies, Fungal / Q000097:blood; D000946:Antigens, Fungal / Q000097:blood* / Q000276:immunology; D041022:Candida tropicalis / Q000276:immunology / Q000302:isolation & purification*; D002177:Candidiasis / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D006801:Humans; D007945:Leukemia, Lymphoid / Q000150:complications / Q000276:immunology* / Q000382:microbiology; D008297:Male; D008351:Mannans / Q000097:blood / Q000276:immunology; D009503:Neutropenia / Q000150:complications
chemical_list: D000908:Antibodies, Fungal; D000946:Antigens, Fungal; D008351:Mannans