Rationale: Opportunistic infections frequently develop in immunocompromised patients, such as those with hematological malignancies, causing significant mortality. Early diagnosis of invasive fungal infections is often important and difficult due to the difficult nature of confirming infection using cytologic and histologic findings. However, we report the first case of candidal infection leading to muscle abscesses in the legs of a patient with leukemia.
Patient concerns: A 60-year-old man with acute myeloid leukemia (AML) presented with multifocal muscle abscesses of the legs.
Diagnoses: Multifocal muscle candidiasis of the legs was confirmed by fine-needle aspiration biopsy of 2 of the calf lesions.
Interventions: After treatment with amphotericin B and flucytosine for 1 month, the patient was administered intravenous caspofungin for 3 months.
Outcome: A CT scan of the abdomen and an MRI of the lower calves showed significant improvement.
Lessons: This case highlights that fungal infection should be considered when patients present with multiple abscesses, emphasizing the value of early biopsy to confirm diagnosis and facilitate precision treatment.