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Fungal feeding-line infections: beware the eyes and teeth.

Authors: H M A Towler; J E Lennard-Jones; A J Simpson; J M D Nightingale;

Fungal feeding-line infections: beware the eyes and teeth.

Abstract

Twenty-four fungal feeding-line infections occurred in 17 patients during 1984-1992. Thirteen were receiving long-term home parenteral feeding and, in them, the first infection occurred after a median of 30 months (range 1-120) continuous feeding with a line that had been in situ for a median of 20 months (range 1-37). Four were receiving short-term feeding through a line that had been inserted 1-2 months previously. At the time of the first infection all patients were febrile and most were anaemic (15/16), however a leucocytosis was rare (three of 16). The fungi isolated were Candida albicans(6), Candida parapsilosis(5), Candida glabrata(2), Candida guillermondii(2) and other species (2). In 16 patients, the feeding-line was removed at the time of the first infection and no other treatment was given, and no other complications occurred in eight (50%) of these. In 11, the line was reinserted a median of 7 days after removal (range 1-11). Four patients (24%) developed a Candida infection of the eye 1-8 weeks after the diagnosis, uveitis (2) and endophthalmitis (2) which, in one patient, led to complete blindness in one eye. Two patients had recurrent infections which began within a month of dental therapy. In one, the infections stopped after dental extractions and, in the other, after a dental clearance. An ophthalmoscopic examination should be performed in all patients with a fungal feeding-line infection. Recurrent candidal infections may have a dental origin.

Keywords

Parenteral Nutrition, Recurrence, Tooth Diseases, Candidiasis, Equipment Contamination, Humans, Female, Middle Aged, Eye Infections, Fungal, Long-Term Care

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
8
Average
Top 10%
Average
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