title: Surgical management of catheter tip thrombus: surgical therapy for right atrial thrombus and fungal endocarditis (Candida tropicalis) complicating paediatric sickle-cell disease.
abstract: The use of indwelling central catheters for long-term administration of hyperalimentation, chemotherapy or other intravenous therapies is increasing. This unusual presentation of a catheter-induced right atrial thrombus was complicated by fungal infection. We present a case of a paediatric sickle-cell patient who underwent surgical removal of a right atrial thrombus secondary to fungal (Candida tropicalis) endocarditis from an indwelling catheter. Successful thrombus removal utilizing cardiopulmonary bypass and subsequent discharge underscores the importance of surgical therapy in treating this important complication.
authors.affiliation: Eastern Heart Associates, Savannah, Georgia, USA. micpumper@aol.com
authors.forename: M J
authors.initials: MJ
authors.lastname: Hollingsed
authors.forename: J M
authors.initials: JM
authors.lastname: Morales
authors.forename: P T
authors.initials: PT
authors.lastname: Roughneen
authors.forename: K D
authors.initials: KD
authors.lastname: Burch
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000755:Anemia, Sickle Cell / Q000150:complications*; D000935:Antifungal Agents / Q000627:therapeutic use; D001803:Blood Transfusion / Q000295:instrumentation; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004617:Embolism / Q000517:prevention & control; D004696:Endocarditis / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D006325:Heart Atria; D006331:Heart Diseases / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D012141:Respiratory Tract Infections / Q000150:complications; D013927:Thrombosis / Q000209:etiology / Q000601:surgery*
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B