Hepatosplenic candidiasis: wheels within wheels

Eight immunocompromised cancer patients with tissue-proved candidiasis underwent serial abdominal ultrasound (US) and computed tomography (CT). At US, four patterns of hepatic and splenic candidiasis were recognized, one of which the authors call a "wheels-within-wheels" pattern. In additi...

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Bibliographic Details
Published inRadiology Vol. 166; no. 2; p. 417
Main Authors Pastakia, B, Shawker, T H, Thaler, M, O'Leary, T, Pizzo, P A
Format Journal Article
LanguageEnglish
Published United States 01.02.1988
Subjects
Abscess - diagnosis
Adolescent
Adult
Candidiasis - diagnosis
Female
Humans
Immune Tolerance
Liver Abscess - diagnosis
Male
Splenic Diseases - diagnosis
Tomography, X-Ray Computed
Ultrasonography
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Summary:Eight immunocompromised cancer patients with tissue-proved candidiasis underwent serial abdominal ultrasound (US) and computed tomography (CT). At US, four patterns of hepatic and splenic candidiasis were recognized, one of which the authors call a "wheels-within-wheels" pattern. In addition, periportal linear areas of increased attenuation, possibly calcified, were identified at follow-up, nonenhanced CT. Some abscesses were better seen on nonenhanced CT scans, while others became visible only with enhancement. Although lesions not seen at US were often seen at CT, the opposite was also true. In two cases, pathologic proof of candidiasis was established even when all imaging studies were normal. For maximum imaging sensitivity, patients should be studied with US and nonenhanced and enhanced CT. Even when both US and CT scans are negative, if there is a strong clinical suggestion of candidiasis, open biopsy is recommended.
ISSN:0033-8419
1527-1315
DOI:10.1148/radiology.166.2.3275982