Korean J Med.  2013 May;84(5):759-763.

Septic Pulmonary Artery Thrombosis with Multiple Pulmonary Embolisms Caused by Candida tropicalis

• Kwon EG
• Chang HH
• Kim SW
• Kim HI
• Kim HH
• Jeong JY
• Jung HY

Abstract

Septic pulmonary thromboembolism resulting from fungal infection is rare. A 32-year-old woman with acute paraquat intoxication was treated with high-dose intravenous steroid and cyclophosphamide pulse therapy. She presented with a prolonged fever, dyspnea, and multiple pneumonic infiltrations. Central venous catheterization was necessary for total parenteral nutrition. The response to antibiotic therapy was disappointing and Candida tropicalis was cultured in the blood repeatedly. Vegetations were found in the superior vena cava on echocardiography and both pulmonary arteries had massive thromboembolism on computed tomography (CT). Intravenous amphotericin B and anticoagulation therapy showed improvement. When patients with central venous catheters and recurrent fungemia present with dyspnea and fever, septic pulmonary thromboembolism and other disseminated infections, such as infective endocarditis or endophthalmitis, should be kept in mind.

Keyword

Pulmonary thromboembolism; Fungemia; Candida tropicalis

MeSH Terms

Amphotericin B
Candida
Candida tropicalis
Catheterization, Central Venous
Central Venous Catheters
Cyclophosphamide
Dyspnea
Echocardiography
Endocarditis
Endophthalmitis
Female
Fever
Fungemia
Humans
Paraquat
Parenteral Nutrition, Total
Pulmonary Artery
Pulmonary Embolism
Thromboembolism
Thrombosis
Vena Cava, Superior
Amphotericin B
Cyclophosphamide
Paraquat