Successful treatment of fungal central thrombophlebitis by surgical thrombectomy in Korea: a case report

Fungal thrombophlebitis of the central vein is a rare, life-threatening disease associated with significant morbidity and mortality. It requires immediate central venous catheter removal and intravenous antifungal therapy, combined in some cases with either anticoagulation or aggressive surgical deb...

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Main Authors: Eun Ji Lee, Jihoon T. Kim
Format: Article
Language:English
Published: Korean Society of Traumatology 2023-09-01
Series:Journal of Trauma and Injury
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Online Access:http://jtraumainj.org/upload/pdf/jti-2022-0063.pdf
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author Eun Ji Lee
Jihoon T. Kim
author_facet Eun Ji Lee
Jihoon T. Kim
author_sort Eun Ji Lee
collection DOAJ
description Fungal thrombophlebitis of the central vein is a rare, life-threatening disease associated with significant morbidity and mortality. It requires immediate central venous catheter removal and intravenous antifungal therapy, combined in some cases with either anticoagulation or aggressive surgical debridement. A 70-year-old male patient injured by a falling object weighing 1,000 kg was transferred to our hospital. A contained rupture of the abdominal aorta with retroperitoneal hematoma was treated with primary aortic repair, and a small bowel perforation with mesenteric laceration was treated with resection and anastomosis. After a computed tomography scan, the patient was diagnosed with thrombophlebitis of the left internal jugular vein and brachiocephalic vein. Despite antifungal treatment, fever and candidemia persisted. Therefore, emergency debridement and thrombectomy were performed. After the operation, the patient was treated with an oral antifungal agent and direct oral anticoagulants. During a 1-year follow-up, no signs of candidemia relapse were observed. There is no optimal timing of surgical treatment for relapsed fungal central thrombophlebitis. Surgical treatment should be considered for early recovery.
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spelling doaj-art-2bb8d105dc224177bad3911d95af069d2025-08-20T02:41:17ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832023-09-0136327628010.20408/jti.2022.00631243Successful treatment of fungal central thrombophlebitis by surgical thrombectomy in Korea: a case reportEun Ji Lee0Jihoon T. Kim1 Department of Trauma Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea Department of Trauma Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, KoreaFungal thrombophlebitis of the central vein is a rare, life-threatening disease associated with significant morbidity and mortality. It requires immediate central venous catheter removal and intravenous antifungal therapy, combined in some cases with either anticoagulation or aggressive surgical debridement. A 70-year-old male patient injured by a falling object weighing 1,000 kg was transferred to our hospital. A contained rupture of the abdominal aorta with retroperitoneal hematoma was treated with primary aortic repair, and a small bowel perforation with mesenteric laceration was treated with resection and anastomosis. After a computed tomography scan, the patient was diagnosed with thrombophlebitis of the left internal jugular vein and brachiocephalic vein. Despite antifungal treatment, fever and candidemia persisted. Therefore, emergency debridement and thrombectomy were performed. After the operation, the patient was treated with an oral antifungal agent and direct oral anticoagulants. During a 1-year follow-up, no signs of candidemia relapse were observed. There is no optimal timing of surgical treatment for relapsed fungal central thrombophlebitis. Surgical treatment should be considered for early recovery.http://jtraumainj.org/upload/pdf/jti-2022-0063.pdfthrombophlebitisthrombectomycandidemiajugular veinscase reports
spellingShingle Eun Ji Lee
Jihoon T. Kim
Successful treatment of fungal central thrombophlebitis by surgical thrombectomy in Korea: a case report
Journal of Trauma and Injury
thrombophlebitis
thrombectomy
candidemia
jugular veins
case reports
title Successful treatment of fungal central thrombophlebitis by surgical thrombectomy in Korea: a case report
title_full Successful treatment of fungal central thrombophlebitis by surgical thrombectomy in Korea: a case report
title_fullStr Successful treatment of fungal central thrombophlebitis by surgical thrombectomy in Korea: a case report
title_full_unstemmed Successful treatment of fungal central thrombophlebitis by surgical thrombectomy in Korea: a case report
title_short Successful treatment of fungal central thrombophlebitis by surgical thrombectomy in Korea: a case report
title_sort successful treatment of fungal central thrombophlebitis by surgical thrombectomy in korea a case report
topic thrombophlebitis
thrombectomy
candidemia
jugular veins
case reports
url http://jtraumainj.org/upload/pdf/jti-2022-0063.pdf
work_keys_str_mv AT eunjilee successfultreatmentoffungalcentralthrombophlebitisbysurgicalthrombectomyinkoreaacasereport
AT jihoontkim successfultreatmentoffungalcentralthrombophlebitisbysurgicalthrombectomyinkoreaacasereport