A CASE OF FUNGAL HEPATIC AND SPLENIC ABSCESSES ASSOCIATED WITH LEUKEMIA

A 57-year-old female was seen at another clinic because of diarrhea and abdominal pain in July, 1994. Since abnormal findings were pointed out in the blood examination, she was referred to the hospital and was diagnosed as acute promyelocytic leukemia (APL). After one course of BHAC-DMP therapy, fever raised up to 38_??_39°C and CRP also raised up. With abdominal US and CT, she was diagnosed as multiple splenic abscesses and cholecystolithiasis. Splenectomy and cholecystectomy were performed on November 25, 1994. Liver biopsy was also performed during the operation, since a lot of small indurations similar to those of the spleen were recognized in the liver. The weight of the spleen was 260 g and multiple small abscesses which sized 5_??_10 mm were also recognized in the section. They were pathologically diagnosed as fungal splenic and hepatic abscesses. After the operation, antifungal agent was also administrated systemically for the rest abscesses in the liver and the patient was discharged from the hospital on the postoperation day 10. We successfully treated a case of fungal hepatic and splenic abscesses occurred during the chemotherapy for leukemia and systemic administration of antifungal agent, for which there has been no established definitive therapy as yet.