[Central venous catheter-related thrombosis with infection in cancer patients--2 cases].
Cancer patients receive intensive chemotherapy by central venous catheter (CVC). Generally, there is a major risk of CVC-related thrombosis and infection due to their hematological and immunological status, respectively. Recently, catheter-induced thrombosis caused by CVC-related bloodstream infection (BSI) has drawn attention in cancer patients. We observed a cohort of patients who received central venous catheterization for one year and described 2 cases of severe thrombosis associated with catheterization and its related infection. In both cases, neutropenic fever was followed by extended subcutaneous swelling with tenderness around the CVC-inserted site after intensive chemotherapy for malignant lymphoma. Chest CT revealed more severe thrombosis around the subclavian and cervical veins, but no mural thrombus on the contralateral site, in both cases. The thrombus included the air cavity, and was thought to be a sign of septic thrombi. Although the issue of the mechanism of infectious thrombosis associated with CVC insertion was not fully addressed, this rare but severe complication of CVC insertion should be studied descriptively and prevented by identification of risks and clinical signs.
Imataki
Osamu
O
Division of Hematology & Stem Cell Transplantation, Shizuoka Cancer Center.
Tamai
Yotaro
Y
Watanabe
Mari
M
Abe
Yoshiaki
Y
Kawakami
Kimihiro
K
D016470:Bacteremia / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects; D015331:Cohort Studies; D004866:Equipment Contamination / Q000517:prevention & control; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007938:Leukemia / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications; D009894:Opportunistic Infections / Q000209:etiology; D013927:Thrombosis / Q000209:etiology*