PMID- 37750159
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230928
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 8
DP  - 2023 Aug
TI  - Successful Treatment of Chronic Disseminated Candidiasis Complicated by Immune 
      Reconstitution Inflammatory Syndrome in a Child With Acute Lymphocytic Leukemia.
PG  - e44103
LID - 10.7759/cureus.44103 [doi]
LID - e44103
AB  - Chronic disseminated candidiasis (CDC) is a severe form of disseminated fungal 
      infection that commonly affects the liver, spleen, and kidneys. In rare cases, 
      CDC can be further complicated by an excessive immune response known as immune 
      reconstitution inflammatory syndrome (IRIS). This syndrome occurs during the 
      phase of immune recovery and is characterized by a systemic inflammatory response 
      and excessive release of cytokines. We present a case of a two-year-old female 
      with a medical history of acute lymphocytic leukemia on chemotherapy. She was 
      admitted with high fever refractory to conservative management that included 
      broad-spectrum antimicrobials. Additionally, multiple skin lesions and a 
      left-sided limp were noted. Whole-body imaging revealed multiple abscesses in the 
      spleen, kidneys, scalp, and left lower limb. The culture of an aspirate material 
      from skin lesions grew Candida tropicalis. Despite receiving appropriate 
      antifungals, the patient showed no signs of improvement, leading to the diagnosis 
      of CDC-induced IRIS. The patient was started on systemic corticosteroids, which 
      resulted in rapid improvement in the patient's clinical status, resolution of 
      fever, and significant reduction in inflammatory markers.
CI  - Copyright (c) 2023, Mosleh et al.
FAU - Mosleh, Sultan
AU  - Mosleh S
AD  - Pediatrics Hematology and Oncology, An-Najah National University Hospital, 
      Nablus, PSE.
FAU - Rabaia, Dima
AU  - Rabaia D
AD  - Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, 
      PSE.
FAU - Zidan, Thabet
AU  - Zidan T
AD  - Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, 
      PSE.
LA  - eng
PT  - Case Reports
DEP - 20230825
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10518137
OTO - NOTNLM
OT  - acute lymphoblastic leukemia
OT  - chronic disseminated candidiasis
OT  - corticosteroids
OT  - hepatosplenic candidiasis
OT  - immune reconstitution inflammatory syndrome
OT  - invasive fungal infection
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/09/26 06:44
MHDA- 2023/09/26 06:45
PMCR- 2023/08/25
CRDT- 2023/09/26 03:37
PHST- 2023/08/25 00:00 [accepted]
PHST- 2023/09/26 06:45 [medline]
PHST- 2023/09/26 06:44 [pubmed]
PHST- 2023/09/26 03:37 [entrez]
PHST- 2023/08/25 00:00 [pmc-release]
AID - 10.7759/cureus.44103 [doi]
PST - epublish
SO  - Cureus. 2023 Aug 25;15(8):e44103. doi: 10.7759/cureus.44103. eCollection 2023 
      Aug.