Fluconazole in the Treatment of Hepatosplenic Candidiasis

Michael T. Flannery, David B. Simmons, Hussain Saba, Philip Altus, Paul M. Wallach, Harold M. Adelman

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Hepatosplenic candidiasis has increased in frequency among immunocompromised hosts. Risk factors include hematologic malignancy, intensive chemotherapy, prolonged neutropenia, and treatment with broad-spectrum antibiotics. Patients most commonly present with abdominal pain, persistent fevers despite antibiotic therapy, and an elevated alkaline phosphatase level that is out of proportion to other hepatic enzyme levels. Gastrointestinal mucosal damage secondary to intensive chemotherapy may allow colonization with Candida species and subsequent seeding of the portal vein. Treatment has consisted of prolonged courses of amphotericin B, with mortality rates approaching 50%. We report a case of hepatosplenic candidiasis in a patient with acute myelogenous leukemia who had clinical and radiographic improvement during fluconazole therapy. Fluconazole may be an efficacious and less toxic alternative to amphotericin B.

Original languageEnglish (US)
Pages (from-to)406-408
Number of pages3
JournalArchives of Internal Medicine
Issue number2
StatePublished - Feb 1992
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine


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