Catheter Complications of Total Parenteral Nutrition -Therapeutic Problems for Fungal Endophthalmitis-

Ryuichiro Okamoto, Yoshifumi Hiramatsu, Hiroaki Kitade, Toshiaki Sanada, Yoshifumi Kojima, Yuusai Kawaguchi, Koshiro Hioki, Masakatsu Yamamoto, Hiroshiko Miki*, Masanobu Uyama*

Department of Surgery and Ophthalmology*, Kansai Medical University

To clarify the incidence and causal factors of catheter sepsis, we studied 715 patients who received total parenteral nutrition from 1986 to 1988 in the Surgical Department at Kansai Medical University. The incidence of catheter sepsis was 17.4% and the culture of the catheter tips was positive in 55 patients (36%). Candida was the most common organism in catheter sepsis (56%) and endogenous fungal endophthalmitis developed in four patients as a part of disseminated candidiasis. Apparently unrecognized systemic candida infection may be more frequent in patients receiving hyperalimentation than was previously suspected. Ophthalmoscopy should be routinely used to manage the patients with catheter sepsis. This should facilitate the early detection and diagnosis of endophthalmitis.

Key words
total parenteral nutrition, complications of central venous catheter, sepsis due to central venous catheter, fungal endophthalmitis, endogenous candidiasis

Reprint requests
Yoshifumi Hiramatsu Department of Surgery, Kansai Medicine University
1 Fumizonocho, Moriguchi, 570 JAPAN

Accepted
April 11, 1990

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