Premium
Thrombolytic therapy for management of complicated catheter‐related Candida albicans thrombophlebitis
Author(s) -
Block A. A.,
Thursky K. A.,
Worth L. J.,
Slavin M. A.
Publication year - 2009
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/j.1445-5994.2008.01867.x
Subject(s) - medicine , urokinase , catheter , thrombolysis , thrombus , central venous catheter , surgery , embolization , candida albicans , thrombosis , biology , myocardial infarction , genetics
In immunocompromised patients, endovascular infection due to Candida albicans is associated with significant morbidity and mortality. Recommended management includes removal of any existing central venous catheter. Rarely, complications of endocarditis or infected mural thrombi may arise, with poorer clinical outcomes. For large endoluminal lesions, particularly of the great vessels or those that are intra‐atrial, thrombolysis has been used in paediatric populations or before surgery for dissolution of infected thrombus. We describe the case of an adult patient with lung carcinoma who developed persisting candidaemia with a large endovascular fungal lesion adherent to the tip of a peripherally inserted central venous catheter. Local urokinase infusion enabled safe removal of the catheter without embolization. As an adjunct to antifungal therapy, local thrombolysis may play a contributory role in the management of central venous catheter‐related candidal septic thrombosis.