Vascular catheter-associated fungemia in patients with cancer: analysis of 155 episodes

Clin Infect Dis. 1992 Apr;14(4):875-83. doi: 10.1093/clinids/14.4.875.


We reviewed all 155 episodes of central venous catheter-associated fungemia among inpatients at the National Cancer Institute during a 10-year period. Candida species accounted for 98% of episodes. Fungemia was documented by culture of blood drawn through catheters in 50% of cases and by culture of both catheter-drawn and peripheral blood in 39%; mortality and the rate of dissemination were similar for these two groups. Four management strategies were used: catheter removal, antifungal therapy (with amphotericin B), both, or neither; indications for the use of both modes of treatment included fever, neutropenia, long-term indwelling catheterization, positive cultures of both catheter-drawn and peripheral blood, isolation of Candida tropicalis, and fungal isolation from two or more blood cultures. Disseminated fungal infection was documented in 82% of cases with these features but also in 35% of the less severe cases treated only with catheter removal. In addition, nine (82%) of 11 cases managed only with antifungal therapy had a negative outcome (either death from disseminated infection or the recurrence of fevers and/or fungemia), a finding suggesting that intravascular catheters should be removed in fungemia. Virtually all cases of catheter-associated fungemia in patients with cancer are clinically significant and require prompt therapy with amphotericin B.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amphotericin B / therapeutic use
  • Candidiasis / etiology
  • Candidiasis / therapy
  • Catheterization, Central Venous*
  • Catheters, Indwelling*
  • Chemotherapy, Adjuvant
  • Child
  • Child, Preschool
  • Cross Infection / etiology*
  • Cross Infection / therapy
  • Female
  • Fungemia / etiology*
  • Fungemia / therapy
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / drug therapy
  • Neutropenia / complications
  • Retrospective Studies


  • Amphotericin B