Sharma J, Nagraj A, Allapathi D, Rajegowda B, Leggiadro R
Division of Pediatric Cardiology, Neonatology and Infectious Disease, Department of Pediatrics, Lincoln Medical and Mental Health Center, 234, East 149 Street, Bronx, NY 11451.
Images Paediatr Cardiol. 2009 Oct;11(4):6-11.
The incidence of fungal endocarditis in premature infants is on the rise, reported in the last decade secondary to use of central venous lines, the frequent use of broad spectrum antibiotics and neonatal surgical interventions. Central line related thrombosis is a significant risk factor for persistent fungemia and end organ complications including endocarditis. We present a fatal case of progressive thrombosis of the inferior vena cava and right atrial mycetoma in a premature infant with candidemia who underwent ileostomy for bowel perforation. Renal failure occurred secondary to inferior vena cava thrombosis and right atrial mycetoma, both of which had a potential for hemodynamic compromise and embolism.
早产儿真菌性心内膜炎的发病率呈上升趋势，在过去十年中有报道称，这是由于使用中心静脉导管、频繁使用广谱抗生素以及新生儿外科手术干预所致。中心静脉导管相关血栓形成是持续性真菌血症和包括心内膜炎在内的终末器官并发症的重要危险因素。我们报告了一例早产儿念珠菌血症患者，因肠穿孔行回肠造口术，发生了下腔静脉进行性血栓形成和右心房真菌瘤，最终死亡。肾衰竭继发于下腔静脉血栓形成和右心房真菌瘤，这两者都有可能导致血流动力学损害和栓塞。
