HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Moore, N. J. E. Articles by Pang, Y. Search for Related Content PubMed PubMed Citation Articles by Moore, N. J. E. Articles by Pang, Y. Related Collections General

Systemic Candidiasis¹

¹ From the Departments of Radiology and Pathology, University of Vermont School of Medicine, 111 Colchester Ave, Burlington, VT 05401. Received November 13, 2002; revision requested January 15, 2003 and received February 28; accepted March 5. Address correspondence to N.J.E.M. (e-mail: Nicholas.J.Moore@vtmednet.org).

View larger version (75K): [in a new window]   Figure 1a.  Systemic candidiasis. (a) Axial contrast-enhanced CT scan shows bilateral pleural effusions (arrows) and a pericardial effusion (arrowhead), nonspecific findings that are consistent with Candida involvement in the chest. (b) CT scan shows countless 1-mm hypoattenuating areas throughout the liver and spleen in a predominantly peripheral distribution (arrows), a finding that is consistent with Candida microabscesses. (c) CT scan demonstrates multiple similar hypoattenuating areas in the right kidney (arrows) that also proved to be Candida abscesses.

View larger version (108K): [in a new window]   Figure 1b.  Systemic candidiasis. (a) Axial contrast-enhanced CT scan shows bilateral pleural effusions (arrows) and a pericardial effusion (arrowhead), nonspecific findings that are consistent with Candida involvement in the chest. (b) CT scan shows countless 1-mm hypoattenuating areas throughout the liver and spleen in a predominantly peripheral distribution (arrows), a finding that is consistent with Candida microabscesses. (c) CT scan demonstrates multiple similar hypoattenuating areas in the right kidney (arrows) that also proved to be Candida abscesses.

View larger version (125K): [in a new window]   Figure 1c.  Systemic candidiasis. (a) Axial contrast-enhanced CT scan shows bilateral pleural effusions (arrows) and a pericardial effusion (arrowhead), nonspecific findings that are consistent with Candida involvement in the chest. (b) CT scan shows countless 1-mm hypoattenuating areas throughout the liver and spleen in a predominantly peripheral distribution (arrows), a finding that is consistent with Candida microabscesses. (c) CT scan demonstrates multiple similar hypoattenuating areas in the right kidney (arrows) that also proved to be Candida abscesses.

View larger version (92K): [in a new window]   Figure 2a.  Hepatic candidiasis. (a, b) Photographs of the sectioned liver (a) and the liver capsule (b) demonstrate 1-3-mm Candida microabscesses beneath the serosal surface and throughout the parenchyma. (c) On a photomicrograph (original magnification, x100; hematoxylin-eosin [H-E] stain) of the liver, each hepatic microabscess is filled with a mixture of inflammatory cells and necrotic debris. At higher-power photomicrography, yeast forms and pseudohyphae were also seen within the hepatic microabscesses. The fibrous capsule surrounding the microabscesses suggests that these lesions developed over several weeks.

View larger version (114K): [in a new window]   Figure 2b.  Hepatic candidiasis. (a, b) Photographs of the sectioned liver (a) and the liver capsule (b) demonstrate 1-3-mm Candida microabscesses beneath the serosal surface and throughout the parenchyma. (c) On a photomicrograph (original magnification, x100; hematoxylin-eosin [H-E] stain) of the liver, each hepatic microabscess is filled with a mixture of inflammatory cells and necrotic debris. At higher-power photomicrography, yeast forms and pseudohyphae were also seen within the hepatic microabscesses. The fibrous capsule surrounding the microabscesses suggests that these lesions developed over several weeks.

View larger version (205K): [in a new window]   Figure 2c.  Hepatic candidiasis. (a, b) Photographs of the sectioned liver (a) and the liver capsule (b) demonstrate 1-3-mm Candida microabscesses beneath the serosal surface and throughout the parenchyma. (c) On a photomicrograph (original magnification, x100; hematoxylin-eosin [H-E] stain) of the liver, each hepatic microabscess is filled with a mixture of inflammatory cells and necrotic debris. At higher-power photomicrography, yeast forms and pseudohyphae were also seen within the hepatic microabscesses. The fibrous capsule surrounding the microabscesses suggests that these lesions developed over several weeks.

View larger version (141K): [in a new window]   Figure 3a.  Splenic candidiasis. (a) Photograph of the sectioned spleen shows Candida microabscess formation. (b) Photomicrograph (original magnification, x100; H-E stain) of the spleen demonstrates normal red and white pulp with an adjacent microabscess. Like the hepatic lesions, the abscesses contain inflammatory cells and necrotic debris. The yeast forms are consistent with Candida species.

View larger version (208K): [in a new window]   Figure 3b.  Splenic candidiasis. (a) Photograph of the sectioned spleen shows Candida microabscess formation. (b) Photomicrograph (original magnification, x100; H-E stain) of the spleen demonstrates normal red and white pulp with an adjacent microabscess. Like the hepatic lesions, the abscesses contain inflammatory cells and necrotic debris. The yeast forms are consistent with Candida species.

View larger version (230K): [in a new window]   Figure 4.  Photomicrograph (original magnification, x200; H-E stain) of the kidney shows normal glomerular apparatuses adjacent to a microabscess. Again, note the fibrous pseudocapsule, which suggests that the abscess formed over several weeks.

View larger version (164K): [in a new window]   Figure 5.  Photomicrograph (original magnification, x600; silver stain) of pericardial fluid sediment clearly depicts pseudohyphae and yeast forms, which were also seen in the pleural fluid. These findings correspond to the pericardial and pleural effusions seen at CT.