A case of DIC caused by a central-venous-catheter-related infection after surgery for tongue cancer

We report a case of DIC caused by a central-venous-catheter-related infection after surgery for tongue cancer. In a 61-year-old man with tongue squamous cell carcinoma, a central venous catheter was inserted percutaneously in the subclavian vein using aseptic technique in the operating room to deliver preoperative intra-arterial chemotherapy (CDDP 150mg) with concurrent radiotherapy (20Gy). After chemoradiotherapy, he underwent tumor resection and neck dissection. On the 3rd postoperative day, a high fever above 39 V developed, suggesting sepsis. The central venous catheter was removed on the same day. DIC was diagnosed on blood examination, showing CRP 15.6, platelet count 65000, and FDP 39.2 μg/ml. Heparin and FOY were administered. Fever resolved immediately, and the platelet count and FDP also returned to normal by the 10th postoperative day. A catheter-related infection was diagnosed because culture examinations isolated the same Staphylococcus genus from the catheter tip and arterial blood, as well as 3-day consecutive venous blood samples. Furthermore, susceptibility testing for Staphylococcus genus from the catheter tip, arterial blood, and venous blood samples consistently demonstrated the same sensitivities to antibiotics. Early recognition of central-venous-catheter-related infection and appropriate treatment including prompt removal of the catheter is of great importance in the perioperative management of high-risk patients.