Nguyen M H, Yu V L, Morris A J
Department of Medicine, University of Pittsburgh School of Medicine, PA 15213, USA.
Am J Kidney Dis. 1996 Apr;27(4):596-8. doi: 10.1016/s0272-6386(96)90173-0.
Arteriovenous fistula infection is an exceedingly rare manifestation of Candida infection, with only one case previously reported in the English literature. This report describes three cases of Candida arteriovenous fistula infection seen in a prospective study and reviews the previously reported case. All cases involved the polytetrafluoroethylene graft. The presentations can be either acute or subacute in onset, with drainage at the fistula site as the most common sign. The diagnosis of Candida arteriovenous fistula infection relies on the isolation of the organism from an intraoperative culture of the fistula. Candida was isolated from blood in three of four cases, and wound drainage in two of three cases. Antifungal therapy should be given, but complete removal of the arteriovenous fistula may be necessary for long-term cure.
动静脉瘘感染是念珠菌感染极为罕见的一种表现形式，英文文献中此前仅报道过一例。本报告描述了在一项前瞻性研究中观察到的三例念珠菌性动静脉瘘感染病例，并对先前报道的病例进行了回顾。所有病例均涉及聚四氟乙烯移植物。其临床表现起病可急可亚急性，瘘管部位引流是最常见的体征。念珠菌性动静脉瘘感染的诊断依赖于从瘘管术中培养物中分离出该病原体。四例中有三例血液中分离出念珠菌，三例中有两例伤口引流液中分离出念珠菌。应给予抗真菌治疗，但为实现长期治愈可能有必要完全切除动静脉瘘。
