Candida infection of the arteriovenous fistula used for hemodialysis.

Arteriovenous fistula infection is an exceedingly rare manifestation of Candida infection, with only one case previously reported in the English literature. This report describes three cases of Candida arteriovenous fistula infection seen in a prospective study and reviews the previously reported case. All cases involved the polytetrafluoroethylene graft. The presentations can be either acute or subacute in onset, with drainage at the fistula site as the most common sign. The diagnosis of Candida arteriovenous fistula infection relies on the isolation of the organism from an intraoperative culture of the fistula. Candida was isolated from blood in three of four cases, and wound drainage in two of three cases. Antifungal therapy should be given, but complete removal of the arteriovenous fistula may be necessary for long-term cure.