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Death from inappropriate therapy for Lyme disease
R Patel1, K L Grogg, W D Edwards
1Division of Infectious Diseases, Mayo Clinic and Foundation, Rochester, MN 55905, USA. patel.robin@mayo.edu
Summary
A Candida parapsilosis septic thrombus on a Groshong catheter caused a fatal outcome. Long-term catheter use for unverified chronic Lyme disease contributed to this serious fungal infection.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Clinical Case Reports
Background:
- Central venous catheters are essential for long-term intravenous therapy.
- Catheter-associated infections, including fungal infections, pose significant risks.
- Candida parapsilosis is an opportunistic pathogen increasingly implicated in healthcare-associated infections.
Observation:
- A 30-year-old woman experienced a fatal event linked to a Groshong catheter.
- The catheter had been indwelling for 28 months.
- Intravenous cefotaxime was administered for 27 months for a chronic Lyme disease diagnosis.
Findings:
- A large septic thrombus, identified as Candida parapsilosis, was found on the catheter tip.
- The extensive duration of catheterization and antibiotic use likely predisposed the patient to fungal overgrowth and thrombosis.
- The diagnosis of chronic Lyme disease was unsubstantiated, raising questions about the indication for long-term treatment.
Implications:
- This case highlights the critical risk of fungal catheter-related thrombosis with prolonged central venous catheter use.
- It underscores the importance of judicious antibiotic stewardship and careful evaluation of indications for long-term invasive devices.
- Enhanced surveillance and timely management strategies are crucial for preventing severe outcomes from Candida parapsilosis infections.