Candida septicemia in a pregnant woman with hyperemesis receiving parenteral nutrition.

BACKGROUND

Intravascular catheter placement carries the risk of a life-threatening systemic fungal infection. In addition to antifungal therapy, removal of the catheter is often considered to be an important part of management.

CASE

A 33-year-old multipara with hyperemesis underwent placement of a peripherally inserted central catheter for parenteral nutrition. She subsequently developed candidemia with both blood and the peripherally inserted central catheter tip cultures positive for Candida parapsilosis. The catheter was removed, the patient was started on intravenous amphotericin B, and due to side effects, she was switched to intravenous fluconazole. She recovered fully, was discharged home on oral fluconazole, and delivered a healthy infant at term.

CONCLUSION

Peripherally inserted central catheter placement may be complicated by candidemia. Intravenous fluconazole and removal of the contaminated catheter successfully eradicated systemic infection with C parapsilosis.