IN-SITU MANAGEMENT AND MOLECULAR ANALYSIS OF CANDIDAEMIA RELATED TO ATOTALLY IMPLANTABLE VASCULAR ACCESS IN A CYSTIC-FIBROSIS PATIENT

We describe a case of candidaemia in a paediatric cystic fibrosis (CF) patient with a totally implantable vascular access (TIVA). Serial qua ntitative blood cultures during therapy with amphotericin B delivered via the catheter suggested that the patient was responding to therapy. The TIVA was finally removed because of persistent fever, but its cul ture remained sterile. Randomly amplified polymorphic DNA (RAPD) analy sis of Candida albicans from various anatomical sites showed that the patient's sputum was the most likely source of TIVA contamination. Inv estigation of TIVA-related candidaemia by molecular analysis could gui de rational antifungal chemoprophylaxis of TIVA-related candidaemia.