J Korean Med Sci.  2008 Dec;23(6):1094-1096. 10.3346/jkms.2008.23.6.1094.

Fatal Peripheral Candidal Suppurative Thrombophlebitis in a Postoperative Patient

• Hong SK
• Nam SH
• Kim HC

• KMID: 1107537
• DOI: http://doi.org/10.3346/jkms.2008.23.6.1094

Abstract

We report a case of fatal fungal peripheral suppurative thrombophlebitis, caused by Candida albicans, which was disseminated to the blood, lungs, eyes, and spine. Clinical suspicion and aggressive management are important in managing fungal peripheral suppurative thrombophlebitis. Early clinical suspicion is important in managing fungal peripheral suppurative thrombophlebitis, and radical excision of the affected veins, recognition of metastatic foci, and use of systemic antifungal agents are essential to avoid septic shock and death.

Keyword

Candidemia; Shock, Septic; Thrombophlebitis

MeSH Terms

Amphotericin B/therapeutic use
Anti-Bacterial Agents/therapeutic use
Candida albicans
Candidiasis/blood/*diagnosis/surgery
Echocardiography
Fatal Outcome
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Postoperative Complications/diagnosis/*microbiology
Rectal Neoplasms/diagnosis/surgery
Thrombophlebitis/*diagnosis/microbiology

Figure

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  Fig. 1 Fundoscopic finding shows multiple raised, white, fluffy, cottonball-like chorioretinal lesion.

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  Fig. 2 Sagittal contrast-enhanced T1-weighted MRI shows mild enhancement of the T7 and T8 vertebral bodies, and subligamentous soft tissue with mild enhancement.

Reference

1. Arnow PM, Quimosing EM, Beach M. Consequences of intravascular catheter sepsis. Clin Infect Dis. 1993. 16:778–784.

2. Deitch EA, Marini JJ, Huseby JS. Suppurative Candida phlebitis of a peripheral vein. J Trauma. 1980. 20:618–620.

3. Torres-Rojas JR, Stratton CW, Sanders CV, Horsman TA, Hawley HB, Dascomb HE, Vial LJ. Candidal suppurative peripheral thrombophlebitis. Ann Intern Med. 1982. 96:431–435.

4. Hauser CJ, Bosco P, Davenport M, Davenport M, Ehrensaft D, Latif M, McNamara BT. Surgical management of fungal peripheral thrombophlebitis. Surgery. 1989. 105:510–514.

5. Yackee JM, Topiel MS, Simon GL. Septic phlebitis caused by Candida albicans and diagnosed by needle aspiration. South Med J. 1985. 78:1262–1263.

6. Murray CK, Beckius ML, McAllister K. Fusarium proliferatum superficial suppurative thrombophlebitis. Mil Med. 2003. 168:426–427.

7. Benoit D, Decruyenaere J, Vandewoude K, Benoit D, Roosens C, Hoste E, Poelaert J, Vermassen F, Colardyn F. Management of candidal thrombophlebitis of the central veins: case report and review. Clin Infect Dis. 1998. 26:393–397.

8. Omuta J, Uchida K, Yamaguchi H, Shibuya K. Histopathological study on experimental endophthalmitis induced by bloodstream infection with Candida albicans. Jpn J Infect Dis. 2007. 60:33–39.

9. Garcia E, Granier I, Geissler A, Boespflug MD, Magnan PE, Durand-Gasselin J. Surgical management of Candida suppurative thrombophlebitis of superior vena cava after central venous catheterization. Intensive Care Med. 1997. 23:1002–1004.

10. Haddad MC, Sharif OA, Aideyan OA, Clark DC, Al Shahed MS, Qureshi ZG, Aabed MY, Sammak B, Baydoun TM, Ross JS, Bloem HJ. Infection versus neoplasm in the spine: differentiation by MRI and diagnostic pitfalls. Eur Radiol. 1993. 3:439–446.