Abstract
A 3-year-old girl with acute lymphocytic leukemia developed multiple fungal liver abscess after the induction chemotherapy. She had prolonged fever not responsive to antibiotics and complained of abdominal pain. Hepatosplenomegaly, leukocytosis, high CRP level, elevated serum alkaline phosphatase, and low density areas in liver by computed tomography (CT) were observed. All blood cultures were negative and histological study of a liver biopsy specimen was not diagnostic. The diagnosis of fungal abscess due to Candida was established by positive Candida antigen, β-D-glucan and D-arabinitol level. Antifungal therapy was initiated with oral fluconazole and amphotericin B which was later changed to miconazole. She remained febrile until the 11 th week though Candida antigen and β-D-glucan could not be detected at the 8th week after the initiation of antifungal therapy. At 14th week, the hepatic lesion on CT scan disappeared and was then judged to be cured. The importance of a prompt diagnosis and therapeutic monitoring of candidiasis by detecting the fungal antigen and metabolites is discussed.
