HSIN-YUN SUNChiu Y.-S.JIH-LUH TANGWang J.-L.SHAN-CHWEN CHANGYEE-CHUN CHEN2020-12-292020-12-2920061369-3786https://www.scopus.com/inward/record.uri?eid=2-s2.0-33750483591&doi=10.1080%2f13693780600735445&partnerID=40&md5=555bc3dd661ee60787430d5e72a3faf8https://scholars.lib.ntu.edu.tw/handle/123456789/535396We report a protracted course of disseminated candidiasis due to Candida tropicalis in a 17-year-old man with acute lymphocytic leukemia. Despite adequate antifungal therapy (amphotericin B), C. tropicalis was recovered from biopsy specimens 25 days (skin) and 109 days (kidney) after the first positive blood cultures. While blood cultures became negative for C. tropicalis 11 days after the initiation of treatment, mannanemia persisted and became negative only after 130 days of antifungal therapy. Thus, antigen assays provided indicators of antifungal response. Differential diagnosis was difficult for this patient with the observation of persistent lesions in image studies. With positive results of antigen assays, an invasive procedure might be avoided and preemptive antifungal treatment could be initiated in a timely manner. Anti-mannan antibody remained undetectable up to 164 days after first positive blood culture despite the patient's recovery from neutropenia and recruitment of neutrophils in the tissue (skin).[SDGs]SDG3amphotericin B; antibody; antifungal agent; asparaginase; Candida antigen; cefepime; ceftazidime; cefuroxime; cyclophosphamide; doxorubicin; fluconazole; folinic acid; ifosfamide; mannan; mesna; methotrexate; methylprednisolone sodium succinate; prednisolone; prednisone; vincristine; acute lymphocytic leukemia; adolescent; article; blood culture; Candida tropicalis; candidiasis; case report; chronic disease; clinical feature; death; diagnostic value; differential diagnosis; drug fever; Escherichia coli; febrile neutropenia; fever; follow up; hospital admission; human; image analysis; immunoassay; interstitial nephritis; invasive procedure; kidney biopsy; liver dysfunction; liver toxicity; male; neutrophil count; pyuria; skin biopsy; skin culture; treatment outcome; Adolescent; Antibodies, Fungal; Antigens, Fungal; Candida tropicalis; Candidiasis; Humans; Leukemia, Lymphocytic; Male; Mannans; Neutropenia; Candida; Candida tropicalisjournal article10.1080/1369378060073544517071559