title: [Hepatosplenic candidiasis in paediatric haematology-oncology patients].
abstract: BACKGROUND
  In the last few decades, the survival of children with haematology-oncological malignancies has increased due to more aggressive chemotherapy regimens. This has led to an increase of fungal infections causing significant morbidity and mortality in these patients. Hepatosplenic candidiasis is a disseminated candida infection that affects most commonly the liver and spleen, although other organs may be involved.
  
  
  METHODS
  We performed a retrospective study of 13 paediatric patients diagnosed with hepatosplenic candidiasis from January 2002 to February 2010 in our paediatric haematology-oncology department following the criteria proposed by the EORTC/MSG (European Organization for Research and Treatment of Cancer and Mycoses study group) updated in 2008. We analysed the clinical characteristics, diagnostic methods, treatment and outcome.
  
  
  RESULTS
  The most common symptom of presentation of hepatosplenic candidiasis in our series was persistent fever, up 84.6% of cases, almost all associated with other symptoms. Risk factors for development are non-specific and were present in 92.3% of our patients. The diagnosis of proven infection, which is made by histology or culture, is usually difficult to obtain and in our series it was obtained only in 23.1% of cases. As in our series, diagnosis is often presumptive. Laboratory tests are not useful in the paediatric population and only in one patient we observed an increase in alkaline phosphatase at diagnosis. This result differs from the behaviour of this biological marker in adults. Although prolonged treatment is often necessary for the resolution of the lesions, survival is high with appropriate treatment, 100% in our series.
  
  
  CONCLUSIONS
  The mortality of hepatosplenic candidiasis is low with early and adequate treatment.
authors.affiliation: Servicio de Hemato-Oncología Pediátrica, Hospital Infantil Niño Jesús, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Hernández Marqués
authors.forename: A
authors.initials: A
authors.lastname: Lassaletta-Atienza
authors.forename: M
authors.initials: M
authors.lastname: González-Vicent
authors.forename: J
authors.initials: J
authors.lastname: Sevilla
authors.forename: B
authors.initials: B
authors.lastname: Molina
authors.forename: M
authors.initials: M
authors.lastname: Andión
authors.forename: M
authors.initials: M
authors.lastname: Cormenzana
authors.forename: A
authors.initials: A
authors.lastname: Pérez Martínez
authors.forename: M A
authors.initials: MA
authors.lastname: Díaz
authors.forename: L
authors.initials: L
authors.lastname: Madero
mesh_terms: D000293:Adolescent; D058365:Candidiasis, Invasive / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000382:microbiology*; D012189:Retrospective Studies; D013158:Splenic Diseases / Q000382:microbiology*