中心静脈栄養カテーテルによる乳児真菌性心内膜血栓症の 2 症例

概要

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Two infants who developed intracardiac fungal masses secondary to total parenteral nutrition (TPN) were reported. One patient died, but the other was sucessfully saved. Case 1 was a newborn female infant who was admitted to the hospital with the diagnosis of omphalocele and ventricular septal defect. After the operations for them, she had been receiving TPN because of intolerance of enteral feeding. At 14 months of age, she developed candida sepsis, and at 23 months of age, she died of sudden hypoxemia. Autopsy findings revealed that the tricusped valve was occluded with fungal mass. Case 2 was a newborn female infant who was admitted to the hospital for chronic functional ileus. While she was treated with TPN for 5 months after birth, she suddenly developed candida sepsis. Two-dimentional echocardiography revealed a fungal mass in the right atrium. The fungal mass was detached during medical treatment for candida sepsis and pulmonary embolism supervened. She was treated with anti-coagulant therapy with heparin, urokinase and antithrombin III with favorable results. In this report, the diagnosis and treatment of intracardiac fungal mass and pulmonary, embolism in infants were also discussed.
日本小児外科学会の論文
1990-12-20