• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of annsurgLink to Publisher's site
Ann Surg. Nov 1985; 202(5): 653–658.
PMCID: PMC1250982

Candida septic thrombosis of the great central veins associated with central catheters. Clinical features and management.

Abstract

Candida septic thrombosis of the great central veins is rarely diagnosed during life, and reports of survival with this condition are exceedingly rare. Eight patients with Candida septic thrombosis of the central veins, with six survivors, are reported. Seven of eight patients had multiple organ system failure following surgery or trauma. All patients had received broad spectrum antibiotics and total parenteral nutrition via a central catheter. Every patient showed features of venous thrombosis with localizing extremity edema and high grade candidemia. Intensive amphotericin B therapy (mean daily dose: 0.7 mg/kg) in all patients, combined with 5-fluorocytosine in five cases, resulted in cure and long-term survival in six patients who received 1600 to 3435 mg (mean: 26 mg/kg) total dose. None of these patients developed renal failure, while four showed improving renal function during treatment. In contrast to Candida endocarditis, septic central vein thrombosis caused by Candida appears to be curable medically in the majority of cases with intensive amphotericin B therapy (total dose: greater than or equal to 22 mg/kg), combined when feasible with 5-fluorocytosine.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.5M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Munster AM. Septic thrombophlebitis. A surgical disorder. JAMA. 1974 Nov 18;230(7):1010–1011. [PubMed]
  • Stein JM, Pruitt BA., Jr Suppurative thrombophlebitis. A lethal iatrogenic disease. N Engl J Med. 1970 Jun 25;282(26):1452–1455. [PubMed]
  • Torres-Rojas JR, Stratton CW, Sanders CV, Horsman TA, Hawley HB, Dascomb HE, Vial LJ., Jr Candidal suppurative peripheral thrombophlebitis. Ann Intern Med. 1982 Apr;96(4):431–435. [PubMed]
  • Chastre J, Cornud F, Bouchama A, Viau F, Benacerraf R, Gibert C. Thrombosis as a complication of pulmonary-artery catheterization via the internal jugular vein: prospective evaluation by phlebography. N Engl J Med. 1982 Feb 4;306(5):278–281. [PubMed]
  • Foley FD. The burn autopsy. Fatal complications of burns. Am J Clin Pathol. 1969 Jul;52(1):1–13. [PubMed]
  • Jarrett F, Maki DG, Chan CK. Management of septic thrombosis of the inferior vena cava caused by Candida. Arch Surg. 1978 May;113(5):637–639. [PubMed]
  • Seelig MS. The role of antibiotics in the pathogenesis of Candidainfections. Am J Med. 1966 Jun;40(6):887–917. [PubMed]
  • Krause W, Matheis H, Wulf K. Fungaemia and funguria after oral administration of Candida albicans. Lancet. 1969 Mar 22;1(7595):598–599. [PubMed]
  • Stone HH, Kolb LD, Currie CA, Geheber CE, Cuzzell JZ. Candida sepsis: pathogenesis and principles of treatments. Ann Surg. 1974 May;179(5):697–711. [PMC free article] [PubMed]
  • Curry CR, Quie PG. Fungal septicemia in patients receiving parenteral hyperalimentation. N Engl J Med. 1971 Nov;285(22):1221–1225. [PubMed]
  • Ashcraft KW, Leape LL. Candida sepsis complicating parenteral feeding. JAMA. 1970 Apr 20;212(3):454–456. [PubMed]
  • Ryan JA, Jr, Abel RM, Abbott WM, Hopkins CC, Chesney TM, Colley R, Phillips K, Fischer JE. Catheter complications in total parenteral nutrition. A prospective study of 200 consecutive patients. N Engl J Med. 1974 Apr 4;290(14):757–761. [PubMed]
  • Solomkin JS, Flohr AB, Quie PG, Simmons RL. The role of Candida in intraperitoneal infections. Surgery. 1980 Oct;88(4):524–530. [PubMed]
  • Marsh PK, Tally FP, Kellum J, Callow A, Gorbach SL. Candida infections in surgical patients. Ann Surg. 1983 Jul;198(1):42–47. [PMC free article] [PubMed]
  • Filice G, Yu B, Armstrong D. Immunodiffusion and agglutination tests for Candida in patients with neoplastic disease: inconsistent correlation of results with invasive infections. J Infect Dis. 1977 Mar;135(3):349–357. [PubMed]
  • Goldstein E, Hoeprich PD. Problems in the diagnosis and treatment of systemic candidiasis. J Infect Dis. 1972 Feb;125(2):190–193. [PubMed]
  • Garrison RN, Richardson JD, Fry DE. Catheter-associated septic thrombophlebitis. South Med J. 1982 Aug;75(8):917–919. [PubMed]
  • Solomkin JS, Flohr A, Simmons RL. Candida infections in surgical patients. Dose requirements and toxicity of amphotericin B. Ann Surg. 1982 Feb;195(2):177–185. [PMC free article] [PubMed]
  • Defever KS, Whelan WL, Rogers AL, Beneke ES, Veselenak JM, Soll DR. Candida albicans resistance to 5-fluorocytosine: frequency of partially resistant strains among clinical isolates. Antimicrob Agents Chemother. 1982 Nov;22(5):810–815. [PMC free article] [PubMed]
  • Dixon D, Shadomy S, Shadomy HJ, Espinel-Ingroff A, Kerkering TM. Comparison of the in vitro antifungal activities of miconazole and a new imidazole, R41,400. J Infect Dis. 1978 Aug;138(2):245–248. [PubMed]
  • Brajtburg J, Kobayashi D, Medoff G, Kobayashi GS. Antifungal action of amphotericin B in combination with other polyene or imidazole antibiotics. J Infect Dis. 1982 Aug;146(2):138–146. [PubMed]
  • Warnock DW, Johnson EM, Richardson MD, Vickers CF. Modified response to ketoconazole of Candida albicans from a treatment failure. Lancet. 1983 Mar 19;1(8325):642–643. [PubMed]
  • Sutton A. Miconazole in systemic candidiasis. Arch Dis Child. 1983 Apr;58(4):319–319. [PMC free article] [PubMed]
  • Sud IJ, Feingold DS. Effect of ketoconazole on the fungicidal action of amphotericin B in Candida albicans. Antimicrob Agents Chemother. 1983 Jan;23(1):185–187. [PMC free article] [PubMed]
  • Jordan WM, Bodey GP, Rodriguez V, Ketchel SJ, Henney J. Miconazole therapy for treatment of fungal infections in cancer patients. Antimicrob Agents Chemother. 1979 Dec;16(6):792–797. [PMC free article] [PubMed]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...