title: Successful treatment of Candida-infected caval thrombosis in critically ill infants by low-dose streptokinase infusion.
abstract: Chronic central venous catheters are an important component in the management of chronically ill infants and children. Sepsis and thrombosis are common complications of these catheters. When the combination of Candida sepsis and caval thrombosis occurs, the prognosis is very poor. Lysis of the thrombus is critical to effective therapy and allows preservation of vascular access. We report the successful treatment of four critically ill infants with Candida-infected caval thrombosis treated with low-dose infusion of streptokinase combined with standard antimicrobial therapy. All four infants survived, and in all cases thrombolysis was complete and Candida sepsis resolved. Each of the infants required continued central venous access, which was made possible by resolution of the caval thrombosis. There were no hemorrhagic or other complications of the therapy.
authors.affiliation: Department of Surgery, University of North Carolina School of Medicine, Chapel Hill.
authors.forename: S R
authors.initials: SR
authors.lastname: Lacey
authors.forename: A L
authors.initials: AL
authors.lastname: Zaritsky
authors.forename: R G
authors.initials: RG
authors.lastname: Azizkhan
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy* / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects; D004334:Drug Administration Schedule; D006801:Humans; D007223:Infant; D007263:Infusions, Parenteral; D013300:Streptokinase / Q000008:administration & dosage*; D013927:Thrombosis / Q000150:complications / Q000188:drug therapy*; D014684:Venae Cavae
chemical_list: D000890:Anti-Infective Agents; D013300:Streptokinase