PMID- 22374323
OWN - NLM
STAT- MEDLINE
DCOM- 20120724
LR  - 20120514
IS  - 1460-2091 (Electronic)
IS  - 0305-7453 (Linking)
VI  - 67
IP  - 6
DP  - 2012 Jun
TI  - Usefulness of corticosteroid therapy during chronic disseminated candidiasis: 
      case reports and literature review.
PG  - 1493-5
LID - 10.1093/jac/dks044 [doi]
AB  - OBJECTIVES: Chronic disseminated candidiasis (CDC) is a disseminated fungal 
      infection that is frequently seen in patients undergoing intensive treatment of 
      haematological malignancies. The first signs of CDC appear during neutrophil 
      recovery. Clinical and physiopathological characteristics of CDC suggest it 
      belongs to the spectrum of fungus-related immune reconstitution inflammatory 
      syndrome (IRIS). We report five cases of CDC treated with antifungal therapy and 
      adjuvant corticosteroids to decrease the exacerbated inflammatory response. 
      METHODS: We conducted a retrospective study in the Haematology Department of the 
      University Hospital of Tours, France. The five reported cases were treated for 
      CDC with antifungal therapy and adjuvant corticosteroids. RESULTS: Of the five 
      cases of CDC, one was proven and four were possible, according to the 2008 
      European Organization for Research and Treatment of Cancer (EORTC) 
      classification. All patients were being treated for acute leukaemia. In all 
      cases, symptoms disappeared 2.8 days (range, 1-7) after the beginning of 
      adjunctive corticosteroid therapy. Corticosteroids were administered on average 
      for 146 days (range, 4 weeks-1 year) and antifungal therapy was administered for 
      the duration of chemotherapy consolidation. There was no exacerbation of CDC 
      symptoms during the next round of chemotherapy or bone marrow transplantation. 
      One patient died from relapse of leukaemia. CONCLUSIONS: Within the framework of 
      IRIS, adjuvant corticosteroid therapy could rapidly improve CDC symptoms and 
      allow continued chemotherapy without delay and without compromising the 
      haematological prognosis.
FAU - Chaussade, H
AU  - Chaussade H
AD  - CHRU de Tours, Service de Medecine Interne et Maladies Infectieuses, Tours, 
      France.
FAU - Bastides, F
AU  - Bastides F
FAU - Lissandre, S
AU  - Lissandre S
FAU - Blouin, P
AU  - Blouin P
FAU - Bailly, E
AU  - Bailly E
FAU - Chandenier, J
AU  - Chandenier J
FAU - Gyan, E
AU  - Gyan E
FAU - Bernard, L
AU  - Bernard L
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20120227
PL  - England
TA  - J Antimicrob Chemother
JT  - The Journal of antimicrobial chemotherapy
JID - 7513617
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Antifungal Agents)
SB  - IM
MH  - Adrenal Cortex Hormones/*administration & dosage
MH  - Anti-Inflammatory Agents/*administration & dosage
MH  - Antifungal Agents/administration & dosage
MH  - Candidiasis/*drug therapy/pathology
MH  - Chronic Disease
MH  - Drug Therapy, Combination/methods
MH  - France
MH  - Hematologic Neoplasms/complications
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/drug therapy/pathology
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2012/03/01 06:00
MHDA- 2012/07/25 06:00
CRDT- 2012/03/01 06:00
PHST- 2012/03/01 06:00 [entrez]
PHST- 2012/03/01 06:00 [pubmed]
PHST- 2012/07/25 06:00 [medline]
AID - dks044 [pii]
AID - 10.1093/jac/dks044 [doi]
PST - ppublish
SO  - J Antimicrob Chemother. 2012 Jun;67(6):1493-5. doi: 10.1093/jac/dks044. Epub 2012 
      Feb 27.