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Candidal suppurative peripheral thrombophlebitis

J R Torres-Rojas, C W Stratton, C V Sanders

    Annals of Internal Medicine
    |April 1, 1982
    PubMed
    Summary
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    Persistent candidemia from suppurative peripheral thrombophlebitis is a serious complication of intravenous therapy. Surgical vein excision and antifungal treatment effectively cured five patients with this rare Candida infection.

    Area of Science:

    • Medical Mycology
    • Infectious Diseases
    • Vascular Surgery

    Background:

    • Transient candidemia is frequent during prolonged intravenous therapy.
    • Sustained candidemia often signifies a persistent infection source.
    • Candidal suppurative peripheral thrombophlebitis is an underrecognized complication of intravenous therapy.

    Observation:

    • Six cases of candidemia associated with thrombosed peripheral veins at intravenous sites were identified.
    • Infections presented as Candida septicemia, with or without disseminated candidiasis.
    • Surgical exploration revealed suppurative thrombosed veins with positive Candida cultures.

    Findings:

    • Candida was detected in the luminal clot and vascular wall via special stains.
    • Five of six patients achieved cure through surgical excision of the affected vein.

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  • Antifungal therapy, including amphotericin B and 5-fluorocytosine, was administered to some survivors.

    • Implications:

    • Highlights candidal suppurative peripheral thrombophlebitis as a distinct clinical entity.
    • Emphasizes the importance of surgical intervention for managing this complication.
    • Suggests a combined approach of surgery and antifungal agents for optimal patient outcomes.