title: Disseminated candidiasis developing during prophylaxis with fluconazole in a small-intestine transplant recipient.
abstract: A 31-year-old man underwent immunosuppressive treatment and was treated with 150 mg per day of prophylactic oral fluconazole after receiving a small-intestine transplant. The patient had acute rejection by the end of the first week after the transplant. Endoscopic examination showed white plaques. In blood and urine cultures, growth of Candida albicans was detected. Biopsy specimens showed high levels of conidia and hyphae in all regions. Intravenous treatment with caspofungin was started for the patient. Candidal findings had regressed on follow-up endoscopy. However, the patient died 3 months after transplant because of the effects of immunosuppression on his bone marrow and the development of disseminated intravascular coagulation. Candida species are the most common cause of invasive fungal infections that develop after solid-organ transplant. Following transplant, candidemia may develop during systemic antifungal treatment with a high level of mortality.
authors.affiliation: Izmir Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Sükran
authors.initials: S
authors.lastname: Köse
authors.forename: Melda
authors.initials: M
authors.lastname: Türken
authors.forename: Gülgün
authors.initials: G
authors.lastname: Akkoçlu
authors.forename: Cezmi
authors.initials: C
authors.lastname: Karaca
authors.forename: Süheyla Serin
authors.initials: SS
authors.lastname: Senger
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D002177:Candidiasis / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D007410:Intestinal Diseases / Q000601:surgery*; D007421:Intestine, Small / Q000637:transplantation*; D008297:Male
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole