scholarly journals Adjuvant Corticosteroid Therapy for Chronic Disseminated Candidiasis

2008 ◽  
Vol 46 (5) ◽  
pp. 696-702 ◽  
Author(s):  
F. Legrand ◽  
M. Lecuit ◽  
B. Dupont ◽  
E. Bellaton ◽  
M. Huerre ◽  
...  
Keyword(s):  
Corticosteroid Therapy ◽  
Disseminated Candidiasis ◽  
Chronic Disseminated Candidiasis

Adjuvant Corticosteroid Therapy for Chronic Disseminated Candidiasis in Patients with Acute Leukemia

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4723-4723
Author(s):  
Shenxian Qian ◽  
Kuang Chen
Keyword(s):  
Abdominal Pain ◽  
Acute Leukemia ◽  
Corticosteroid Therapy ◽  
Antifungal Therapy ◽  
Clinical Symptoms ◽  
Conflicts Of Interest ◽  
European Organization ◽  
Disseminated Candidiasis ◽  
Protein Levels ◽  
Chronic Disseminated Candidiasis

Abstract Abstract 4723 Chronic disseminated candidiasis (CDC) is typically observed during neutrophil recovery in patients with acute leukemia and requires protracted antifungal therapy. Our objective was to document the efficacy and tolerance of corticosteroid therapy (CST) in patients with symptomatic CDC, including those who experienced fever and abdominal pain despite ongoing antifungal therapy. We performed a study involving 6 adult patients who experienced ongoing symptomatic CDC despite receipt of appropriate antifungal therapy for whom adjuvant oral CST therapy was initiated. All cases of CDC were proven or probable, as determined on the basis of the European Organization for Research and Treatment of Cancer-Mycosis Study Group definition criteria, and occurred in patients with leukemia.The common manifestations in these six patients were persistent fever, splenohepatomegalia and percussion pain in hepatic region. Meanwhile, 2 of them were accompanied with appearance of painful and diffuse cataneous nodules, expectoration and dyspnoea. The abnormal laboratory test observed of them was increase of alkaline phosphatase. Computed tomography scan showed multiple hypodense lesions in the liver and spleen in all the five patients; one of them showed multiple nodular patchy shadows in bone. Nuclear magnetic resonance imaging showed multiple abnormal signal in liver, spleen and kidneys in one of the patients. Three patients had positive blood candida tropicalis cultures. liver biopsy in one patient was negative for fungal. Two patients received Fluconazole therapy empirically, but it was replaced by Itraconazole later in one because of unresponsiveness to the drug. Three patients received Itraconazole therapy and in one received voriconazole therapy empirically. CDC-attributable clinical symptoms resolved with CST, which was started an average of 31 day since antifungal therapy was initiated. Fever and abdominal pain disappeared a median of 5–6 days, and serum fibrinogen and C-reactive protein levels returned to normal values within 14–30 days. Hepatosplenic microabscesses decreased or disappeared within a mean period of 45 days (range, 27–167 days). All the six patients received further chemotherapy smoothly after the treatment antifungal therapy combined with CST,No relapses of CDC were observed during a median duration of follow-up of 3.2 years (range, 2.6–3.8 years).CONCLUSION: In adults who experience persistently symptomatic CDC despite ongoing receipt of antifungal therapy, CST involving a prednisone equivalent at a dosage of > or =0.25 mg/kg per day for at least 3 weeks is associated with a prompt resolution of symptoms and of inflammatory response. These findings support the pathophysiological hypothesis that CDC belongs to the spectrum of fungus-related immune reconstitution inflammatory syndrome. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Clinical characteristics and outcomes of patients with chronic disseminated candidiasis who need adjuvant corticosteroid therapy

2017 ◽  
Vol 56 (6) ◽  
pp. 782-786 ◽  
Author(s):  
Young-Rock Jang ◽  
Min-Chul Kim ◽  
Taeeun Kim ◽  
Yong Pil Chong ◽  
Sang-Oh Lee ◽  
...  
Keyword(s):  
Corticosteroid Therapy ◽  
Clinical Characteristics ◽  
Disseminated Candidiasis ◽  
Chronic Disseminated Candidiasis

scholarly journals Usefulness of corticosteroid therapy during chronic disseminated candidiasis: case reports and literature review

2012 ◽  
Vol 67 (6) ◽  
pp. 1493-1495 ◽  
Author(s):  
H. Chaussade ◽  
F. Bastides ◽  
S. Lissandre ◽  
P. Blouin ◽  
E. Bailly ◽  
...  
Keyword(s):  
Literature Review ◽  
Corticosteroid Therapy ◽  
Case Reports ◽  
Disseminated Candidiasis ◽  
Chronic Disseminated Candidiasis

Response of Symptomatic Persistent Chronic Disseminated Candidiasis to Corticosteroid Therapy in Immunosuppressed Pediatric Patients

2018 ◽  
Vol 37 (7) ◽  
pp. 686-690 ◽  
Author(s):  
Vered Shkalim-Zemer ◽  
Itzhak Levi ◽  
Salvador Fischer ◽  
Hannah Tamary ◽  
Joanne Yakobovich ◽  
...  
Keyword(s):  
Corticosteroid Therapy ◽  
Pediatric Patients ◽  
Disseminated Candidiasis ◽  
Chronic Disseminated Candidiasis

scholarly journals “Chronic Disseminated Aspergillosis,” a Novel Fungal Immune Reconstitution Inflammatory Syndrome

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Annabelle Pourbaix ◽  
Romain Guery ◽  
Julie Bruneau ◽  
Estelle Blanc ◽  
Gregory Jouvion ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Clinical Presentation ◽  
Castleman Disease ◽  
Disease Symptoms ◽  
Disseminated Candidiasis ◽  
Multicentric Castleman Disease ◽  
Chronic Disseminated Candidiasis ◽  
Disseminated Aspergillosis ◽  
Inflammatory Syndrome

Abstract We report a case of chronic hepatosplenic aspergillosis following immune reconstitution complicating colic aspergillosis in an AIDS patient with multicentric Castleman disease. Symptoms mimicked the clinical presentation of chronic disseminated candidiasis and responded to corticosteroid. This emerging entity enlarges the spectrum of fungal immune reconstitution inflammatory syndrome in the HIV setting.

scholarly journals Chronic Disseminated Candidiasis During Hematological Malignancies: An Immune Reconstitution Inflammatory Syndrome With Expansion of Pathogen-Specific T Helper Type 1 Cells

2019 ◽  
Vol 221 (11) ◽  
pp. 1907-1916 ◽  
Author(s):  
Sophie Candon ◽  
Blandine Rammaert ◽  
Anne Perrine Foray ◽  
Baptiste Moreira ◽  
Maria Pilar Gallego Hernanz ◽  
...  
Keyword(s):  
T Cells ◽  
T Cell ◽  
T Cell Activation ◽  
Immune Reconstitution ◽  
Cell Activation ◽  
Hematological Malignancies ◽  
Invasive Fungal Disease ◽  
Disseminated Candidiasis ◽  
Chronic Disseminated Candidiasis ◽  
Factor Α

Abstract Background Chronic disseminated candidiasis (CDC) is a rare disease that mostly occurs after chemotherapy-induced prolonged neutropenia in patients with hematological malignancies. It is believed to ensue from Candida colonization, breach of the intestinal epithelial barrier, and venous translocation to organs. Fungal blood or liver biopsy cultures are generally negative, suggesting the absence of an ongoing invasive fungal disease. Methods To unravel the contribution of the immune system to CDC pathogenesis, we undertook a prospective multicentric exploratory study in 44 CDC patients at diagnosis and 44 matched controls. Results Analysis of Candida-specific T-cell responses using enzyme-linked immunospot assays revealed higher numbers of interferon (IFN)γ-producing T cells reactive to mp65 or candidin in 27 CDC cases compared with 33 controls. Increased plasma levels of soluble CD25, interleukin (IL)-6, IL-1β, tumor necrosis factor-α, and IL-10 and lower levels of IL-2 were observed in CDC patients versus controls. Neutrophilia and higher levels of CD4 and CD8 T-cell activation were found in CDC patients as well as increased proportions of CXCR3-expressing TCRγδ +Vδ2+ cells. Conclusions The expansion of Candida-specific IFNγ-producing T cells together with features of T-cell activation and systemic inflammation identified here support the view that CDC belongs to the broad spectrum of fungal-associated immune reconstitution inflammatory syndromes.

scholarly journals The usefulness of the PlateliaCandidaantigen in a patient with acute lymphocytic leukemia and chronic disseminated candidiasis

2006 ◽  
Vol 44 (7) ◽  
pp. 647-650 ◽  
Author(s):  
Hsin-Yun Sun ◽  
Yu-Shin Chiu ◽  
Jih-Luh Tang ◽  
Jiun-Ling Wang ◽  
Shan-Chwen Chang ◽  
...  
Keyword(s):  
Acute Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
Disseminated Candidiasis ◽  
Chronic Disseminated Candidiasis
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