Right atrial thrombus in a neonate with Aspergillus colonization secondary to central venous catheter: a case report

TL;DR

A neonate developed a right atrial thrombus with Aspergillus infection due to a central venous catheter, emphasizing the need for early diagnosis and treatment.

Contribution

Presents a rare neonatal case of CRT complicated by Aspergillus colonization, emphasizing diagnostic and therapeutic challenges.

Findings

A neonate with a central venous catheter developed a right atrial thrombus with Aspergillus colonization.

Surgical removal and antifungal therapy led to improvement and discharge after three weeks.

Early recognition and management of CRT and opportunistic infections are critical for neonatal outcomes.

Abstract

Central venous catheter-related thrombosis (CRT) is a recognized complication, particularly in patients with underlying hypercoagulable states. This condition can precipitate several complications, including secondary infections, necessitating immediate and effective diagnosis and management.

In this report, we present a case of a 13-day-old neonate admitted to the neonatal intensive care unit with severe respiratory distress, necessitating the insertion of a central venous catheter for optimal nutrition and treatment. Persistent fever and worsening general condition prompted further investigations, including echocardiography, which revealed a sizeable right atrial mass. Surgical removal of the mass was performed, and subsequent analysis identified thrombosis complicated by Aspergillus colonization. Postoperative management included anticoagulation and antifungal therapy, which were continued for 3 weeks until the patient’s condition improved, leading to discharge.

This case highlights the importance of accurate differential diagnosis of cardiac masses, early recognition and management of CRT in neonates, and the need for timely treatment of opportunistic infections like invasive Aspergillosis for optimal outcomes.

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