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Candidal liver abscesses and cholecystitis in a 37-year-old patient without underlying malignancy
Authors:Lai Chung-Hsu  Chen Hsin-Pai  Chen Te-Li  Fung Chang-Phone  Liu Cheng-Yi  Lee Shou-Dong
Affiliation:1. Section of Infectious Diseases,Department of Medicine, Taipei Veterans General Hospital, Taipei,Taiwan, China
2. Section of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming University, Taipei, Taiwan, China
3. Section of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, and National Yang Ming University, School of Medicine, Taipei, Taiwan, China
Abstract:We report a case of candidal liver abscesses and concomitant candidal cholecystitis in a diabetic patient, in whom differences were noted relative to those found in patients with hematologic malignancies. In our case, the proposed entry route of infection is ascending retrograde from the biliary tract. Bile and aspirated pus culture repeatedly tested positive, and blood negative, for Candida albicans and Candida glabrata. Cholecystitis was cured by percutaneous gallbladder drainage and amphotericin B therapy. The liver abscesses were successfully treated by a cumulative dosage of 750 mg amphotericin B, We conclude that in cases involving less immunocompromised patients and those without candidemia, a lower dosage of amphotericin B may be adequate in treating candidal liver abscesses.
Keywords:Candida  Liver abscess  Cholecystitis  Amphotericin B  Endoscopic papillotomy  Biliary prosthesis
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