Pulmonary vascular candidiasis and use of central venous catheters in neonates

A retrospective study of infant deaths in this maternity hospital carried out from 1976-86 showed a recent increase in fatalities with systemic candidiasis. Ten of twenty five cases occurred between July 1985 and June 1986. Most of these infants had Candida plugging pulmonary vessels, often accompanied by vasculitis, thrombosis, and parenteral lipid embolism. The adoption of central venous catheters for prolonged parenteral feeding of very preterm infants may have accounted for this phenomenon. Over the same decade there was an increased incidence of Candida isolates from all admissions to the neonatal intensive care unit: the prolonged survival of very low birthweight infants and the use of multiple courses of antibiotics were also factors.