title: Hepatosplenic Candidiasis Detected by (18)F-FDG-PET/CT.
abstract: Hepatosplenic candidiasis is a fungal infection, which mostly affects patients with hematologic malignancies such as leukemia. The pathogenesis of this infection is not clear yet, and the liver is the most commonly affected organ. Diagnosis of hepatosplenic candidiasis can be only established via biopsy, since computed tomography (CT) scan, ultrasonography, and magnetic resonance imaging (MRI) yield non-specific results. The role of fluorine-18 fluorodeoxyglucose positron emission tomography /computed tomography ((18)F-FDG PET/CT) in diagnosis of hepatosplenic candidiasis remains undetermined, considering a few evidences in the literature. In this case report, we present the case of a 47-year-old patient, affected by acute myeloid leukemia, which was treated with three cycles of chemotherapy, resulting in the development of neutropenia and fever following the last cycle. The (18)F-FDG PET/CT scan showed some foci of intense FDG uptake in the liver and spleen. The subsequent diagnostic investigations (i.e., abdominal CT scan and biopsy) were suggestive of hepatosplenic candidiasis. The patient was started on antifungal treatment with fluconazole. After one month, the clinical conditions were resolved, and the subsequent abdominal CT scan was negative.
authors.affiliation: Nuclear Medicine, Spedali Civili di Brescia, Brescia, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Albano
authors.affiliation: Nuclear Medicine, Spedali Civili di Brescia, Brescia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Bosio
authors.affiliation: Nuclear Medicine, Spedali Civili di Brescia, Brescia, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Bertoli
authors.affiliation: Department of Molecular and Translational Medicine, Anatomic Pathology Section, Spedali Civili di Brescia, Brescia, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Petrilli
authors.affiliation: Nuclear Medicine, Spedali Civili di Brescia, Brescia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bertagna
keywords: 18F-FDG-PET/CT; Acute myeloid leukemia; Hepatosplenic candidiasis