Redefining Ultrasound's role in early diagnosis of hepatosplenic candidiasis during neutropenia: A pediatric case report in solid tumor

Abstract

We report a case of hepatosplenic candidiasis (HSC) in a neutropenic child with ovarian teratoma. Using high-frequency ultrasonography, we detected subtle hypoechoic pseudonodules in the spleen during profound neutropenia (ANC 30/μL), challenging the dogma that lesions only appear after immune recovery. These precursors evolved into classic "bull's-eye" lesions. Candida tropicalis was confirmed via splenectomy. This case highlights high-frequency ultrasound's role in early HSC diagnosis before neutrophil recovery.