case_images: PMC3909761_01
case_images: Postmortem analysis. A) Postmortem CT of mediastinal window. B) Postmortem CT of lung window. C) Fibrin thrombus in the CV port tube (arrow). D) High-magnification view of the thrombus containing neutrophils and macrophages. E)Candida in the thrombus stained by the periodic acid-Schiff reagent. F) Detection of Candida by Grocott staining.
case_images: 1472-6890-14-6-1.jpg
case_images: PMC3909761_01_1472-6890-14-6-1.jpg
case_images: F1
case_images: Two certified radiologists independently interpreted the images as consistent with acute respiratory distress syndrome (Figure 1A and B), suggesting that the patient's course was complicated by catheter-related sepsis. A cross-section of the catheter that had been inserted into the subclavian vein revealed a fibrin thrombus (Figure 1C) containing neutrophils and macrophages (Figure 1D), indicating that the thrombus had existed while the patient was alive. Staining with the periodic acid-Schiff reagent and the Grocott stain revealed scattered Candida with spores and elongated pseudomycelia in the thrombus (Figure 1E and F). In contrast, by light microscopy, the outer wall of the catheter was clear, without fixations (arrow, Figure 1C).