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Candidal Suppurative Thrombophlebitis in a Premature Infant

M. F. COTTON, FCP (PAED) (SA); F. E. BERKOWITZ, FCP (PAED) (SA); O. J. RANSOME, FCP (PAED) (SA)
Am J Dis Child. 1988;142(3):254-255. doi:10.1001/archpedi.1988.02150030020010.
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Sir.—Candidal suppurative thrombophlebitis has not been previously described in premature infants. Systemic candidiasis with Candida skin abscesses has been documented.1 We describe a premature infant with systemic candidiasis due to candidal suppurative thrombophlebitis.

Patient Report.—A premature infant girl of 32 weeks' gestation received assisted ventilation for severe hyaline membrane disease. Indwelling arterial lines were in place for the first seven days. Fluids, including an amino acid solution, were given via a peripheral vein from day 4. Intravenous cannulae were not changed regularly.

For the first nine days the patient was treated for suspected pneumonia with penicillin G and gentamicin. On day 10 the antibiotic treatment was changed to amikacin and piperacillin.

On day 12 the spleen became palpable for the first time and an area of cellulitis was noted over the dorsum of the right foot, a site of previous intravenous cannulation for approximately 70 hours. The

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