DOI: https://doi.org/10.36347/sasjm.2026.v12i05.015

Pages: 443-448

Systemic candidiasis is a severe invasive fungal infection that mainly affects immunocompromised patients and is associated with significant morbidity and mortality. Although Candida albicans remains a major pathogen, the epidemiology of invasive candidiasis has changed over recent decades, with an increasing incidence of non-albicans Candida species, some of which show intrinsic resistance or reduced susceptibility to commonly used antifungal agents. The clinical presentation is often nonspecific, usually consisting of persistent fever, deterioration of general condition, or sepsis-like manifestations in patients with predisposing factors such as neutropenia, malignancy, major surgery, broad-spectrum antibiotic therapy, central venous catheters, parenteral nutrition, or prolonged intensive care stay. Diagnosis remains challenging and relies on a combination of clinical, microbiological, histopathological, and imaging findings. Imaging plays a crucial role in detecting deep-seated organ involvement, assessing disease extent, guiding biopsy when feasible, and monitoring therapeutic response. Pulmonary candidiasis may present with diffuse randomly distributed micronodules, consolidations, cavitary lesions, or the halo sign. Hepatosplenic and renal candidiasis typically appear as multiple disseminated microabscesses, sometimes showing a bull’s-eye or target appearance and peripheral enhancement. Osteoarticular candidiasis is rare and often manifests as a late complication of hematogenous dissemination, whereas central nervous system involvement may include microabscesses, granulomas, meningitis, ventriculitis, vascular complications, or abscess formation. Despite the nonspecific nature of most imaging findings, their recognition in the appropriate clinical context can strongly support early diagnosis and improve patient management. We report the case of a 3-year-old girl followed for acute myeloid leukemia (AML) and currently receiving chemotherapy, who presented with