Candida thrombosis of the innominate vein with septic pulmonary emboli.
Thrombosis of central veins has become more prevalent because of increased use of long-term central venous catheterization. Candida superinfection of the thrombus can occur particularly in patients on long-term antibiotic therapy and on parenteral nutrition. Removal of the catheter, thrombolytic therapy, anticoagulation, and antifungal therapy with amphotericin B will usually eradicate the candidemia and restore venous patency. Occasionally this therapeutic regimen fails. This case report illustrates such a failure in which multiple pulmonary emboli could have caused death. Surgical thrombectomy of the innominate vein effectively removed the source of the Candida sepsis and maintained patency of a major vein. Thrombectomy should be considered as a therapeutic option in septic central vein thrombosis.
Kelly
R F
RF
University of Southern California University Hospital, Los Angeles.
Yellin
A E
AE
Weaver
F A
FA
D000328:Adult; D016121:Brachiocephalic Veins / Q000601:surgery*; D002177:Candidiasis / Q000601:surgery*; D002405:Catheterization, Central Venous; D016469:Fungemia / Q000382:microbiology; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000382:microbiology*; D013350:Subclavian Vein / Q000601:surgery; D017131:Thrombectomy; D013927:Thrombosis / Q000382:microbiology* / Q000601:surgery*