Candidal Suppurative Peripheral Thrombophlebitis

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Abstract
Transient candidemia is common with prolonged i.v. therapy. Sustained candidemia usually indicates a persistent focus of infection. A complication of i.v. therapy not previously emphasized is persistent candidemia caused by candidal suppurative peripheral thrombophlebitis. Six cases are reported that appeared during i.v. therapy; the infection was characterized by a thrombosed peripheral vein at an i.v. site with manifestations for Candida septicemia with or without disseminated candidiasis. In 2 patients, the source of the process was occult; the examination showed only a thrombosed noninflamed vein. In all cases, surgical exploration showed the thrombosed veins to be suppurative with positive cultures for Candida. Special stains showed Candida in the luminal clot and the vascular wall. In the 5 surviving patients, cure was achieved by excision of the affected vein. Four received a short course of amphotericin B and 5-fluorocytosine; 1 patient received amphotericin B only.

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