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

Background: 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. Case summary: 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. Discussion: 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.