Candida fungus balls in the common bile duct. Unusual manifestation of disseminated candidiasis

Abstract

Disseminated candidiasis appearing as Candida fungus balls in the common bile duct developed in a patient with acute myelogenous leukemia. The patient had received broad-spectrum antimicrobial therapy for fever of unclear origin and subsequently manifested signs of liver cell dysfunction. A percutaneous transhepatic cholangiogram demonstrated three radiolucent defects in the distal part of the common bile duct, which proved to be fungus balls at operation. The liver was studded with microabscesses that disclosed C albicans on biopsy. The biliary tract fungus balls were removed surgically, and the patient was treated with 2,001 mg of intravenously administered amphotericin B over a 2 1/2-month period. No evidence of Candida infection is evident eight months after completion of therapy.