Pulmonary vascular candidiasis and use of central venous catheters in neonates

• Published in: Journal of clinical pathology Vol. 40; no. 5; pp. 559 - 565
• Main Authors: Knox, W F, Hooton, V N, Barson, A J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Association of Clinical Pathologists 01-05-1987; BMJ; BMJ Publishing Group LTD
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Candida - isolation & purification; Candidiasis - etiology; Catheterization - adverse effects; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Humans; Infant, Newborn; Intensive care medicine; Medical sciences; Pulmonary Artery - microbiology; Pulmonary Veins - microbiology; Retrospective Studies; Vascular Diseases - etiology; Vasculitis - microbiology; Human; Infection; Candidiasis; Mycosis; Catheterization; Pulmonary vessel; Umbilical artery; New born; Resuscitation
• ISSN: 0021-9746; 1472-4146
• DOI: 10.1136/jcp.40.5.559

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.