Search tips
Search criteria 


Logo of jrsocmedLink to Publisher's site
J R Soc Med. 1995 May; 88(5): 258–263.
PMCID: PMC1295195

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


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.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (905K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Jones JM. Laboratory diagnosis of invasive candidiasis. Clin Microbiol Rev. 1990 Jan;3(1):32–45. [PMC free article] [PubMed]
  • Curry CR, Quie PG. Fungal septicemia in patients receiving parenteral hyperalimentation. N Engl J Med. 1971 Nov;285(22):1221–1225. [PubMed]
  • Rodrigues RJ, Wolff WI. Fungal septicemia in surgical patients. Ann Surg. 1974 Nov;180(5):741–746. [PubMed]
  • Bodey GP. Fungal infections complicating acute leukemia. J Chronic Dis. 1966 Jun;19(6):667–687. [PubMed]
  • Henderson DK, Edwards JE, Jr, Montgomerie JZ. Hematogenous candida endophthalmitis in patients receiving parenteral hyperalimentation fluids. J Infect Dis. 1981 May;143(5):655–661. [PubMed]
  • Focus on fungal infections: an update on diagnosis and treatment. Phoenix, Arizona, 21-22 February 1991. Clin Infect Dis. 1992 Mar;14 (Suppl 1):S1–181. [PubMed]
  • Lemieux C, St-Germain G, Vincelette J, Kaufman L, de Repentigny L. Collaborative evaluation of antigen detection by a commercial latex agglutination test and enzyme immunoassay in the diagnosis of invasive candidiasis. J Clin Microbiol. 1990 Feb;28(2):249–253. [PMC free article] [PubMed]
  • Walsh TJ, Hathorn JW, Sobel JD, Merz WG, Sanchez V, Maret SM, Buckley HR, Pfaller MA, Schaufele R, Sliva C, et al. Detection of circulating candida enolase by immunoassay in patients with cancer and invasive candidiasis. N Engl J Med. 1991 Apr 11;324(15):1026–1031. [PubMed]
  • Matthews R, Burnie J. Diagnosis of systemic candidiasis by an enzyme-linked dot immunobinding assay for a circulating immunodominant 47-kilodalton antigen. J Clin Microbiol. 1988 Mar;26(3):459–463. [PMC free article] [PubMed]
  • Bougnoux ME, Hill C, Moissenet D, Feuilhade de Chauvin M, Bonnay M, Vicens-Sprauel I, Pietri F, McNeil M, Kaufman L, Dupouy-Camet J, et al. Comparison of antibody, antigen, and metabolite assays for hospitalized patients with disseminated or peripheral candidiasis. J Clin Microbiol. 1990 May;28(5):905–909. [PMC free article] [PubMed]
  • Kan VL. Polymerase chain reaction for the diagnosis of candidemia. J Infect Dis. 1993 Sep;168(3):779–783. [PubMed]
  • Ryan JA, Jr, Abel RM, Abbott WM, Hopkins CC, Chesney TM, Colley R, Phillips K, Fischer JE. Catheter complications in total parenteral nutrition. A prospective study of 200 consecutive patients. N Engl J Med. 1974 Apr 4;290(14):757–761. [PubMed]
  • Weems JJ, Jr, Chamberland ME, Ward J, Willy M, Padhye AA, Solomon SL. Candida parapsilosis fungemia associated with parenteral nutrition and contaminated blood pressure transducers. J Clin Microbiol. 1987 Jun;25(6):1029–1032. [PMC free article] [PubMed]
  • Plouffe JF, Brown DG, Silva J, Jr, Eck T, Stricof RL, Fekety FR., Jr Nosocomial outbreak of Candida parapsilosis fungemia related to intravenous infusions. Arch Intern Med. 1977 Dec;137(12):1686–1689. [PubMed]
  • Eppes SC, Troutman JL, Gutman LT. Outcome of treatment of candidemia in children whose central catheters were removed or retained. Pediatr Infect Dis J. 1989 Feb;8(2):99–104. [PubMed]
  • Miles DA, Van Dis ML, Peterson MG. Information gain at reduced exposure time using a prototype video-enhancement device. Dentomaxillofac Radiol. 1989 Aug;18(3):100–104. [PubMed]
  • Dato VM, Dajani AS. Candidemia in children with central venous catheters: role of catheter removal and amphotericin B therapy. Pediatr Infect Dis J. 1990 May;9(5):309–314. [PubMed]
  • Lecciones JA, Lee JW, Navarro EE, Witebsky FG, Marshall D, Steinberg SM, Pizzo PA, Walsh TJ. Vascular catheter-associated fungemia in patients with cancer: analysis of 155 episodes. Clin Infect Dis. 1992 Apr;14(4):875–883. [PubMed]
  • Brennan MF, Goldman MH, O'Connell RC, Kundsin RB, Moore FD. Prolonged parenteral alimentation: Candida growth and the prevention of candidemia by amphotericin instillation. Ann Surg. 1972 Sep;176(3):265–272. [PubMed]
  • Lopez-Berestein G, Bodey GP, Fainstein V, Keating M, Frankel LS, Zeluff B, Gentry L, Mehta K. Treatment of systemic fungal infections with liposomal amphotericin B. Arch Intern Med. 1989 Nov;149(11):2533–2536. [PubMed]
  • Edwards JE, Jr, Foos RY, Montgomerie JZ, Guze LB. Ocular manifestations of Candida septicemia: review of seventy-six cases of hematogenous Candida endophthalmitis. Medicine (Baltimore) 1974 Jan;53(1):47–75. [PubMed]
  • Parke DW, 2nd, Jones DB, Gentry LO. Endogenous endophthalmitis among patients with candidemia. Ophthalmology. 1982 Jul;89(7):789–796. [PubMed]
  • Brooks RG. Prospective study of Candida endophthalmitis in hospitalized patients with candidemia. Arch Intern Med. 1989 Oct;149(10):2226–2228. [PubMed]
  • Dellon AL, Stark WJ, Chretien PB. Spontaneous resolution of endogenous Candida endophthalmitis complicating intravenous hyperalimentation. Am J Ophthalmol. 1975 Apr;79(4):648–654. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press