A RADIOLOGIC SYNDROME AFTER HIGH-DOSE CHEMOTHERAPY AND AUTOLOGOUS BONE-MARROW TRANSPLANTATION, WITH CLINICAL AND PATHOLOGICAL FEATURES OF SYSTEMIC CANDIDIASIS

Background. The use of high dose chemotherapy in the treatment of soli d tumors is associated with prolonged neutropenia and, consequently, i n some patients, systemic candidiasis. The authors describe their expe rience with a clinicoradiologic syndrome developing after high dose ch emotherapy was administered to patients with breast cancer. Methods. T he authors evaluated the clinical and radiologic records of 12 patient s in whom hepatic, splenic, or renal candidiasis developed. Results. T hree patients had positive blood cultures for candida tropicalis. One of these patients and two others had fungal organisms identified with special stains of an organ aspirate. Most patients were asymptomatic, and most of them were treated successfully with antifungal agents, alt hough untreated patients also recovered. There were no fatalities due to the candidiasis. Conclusions. A radiographic syndrome resembling he patic, splenic, or renal candidiasisis is described, which occurred af ter high dose chemotherapy was administered and autologous bone marrow transplantation was performed on patients with breast cancer. This sy ndrome has a favorable prognosis. Conclusions as to the more indolent nature of this syndrome cannot be made; however, this topic warrants f urther investigation.