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Summary. To prove the hypothesis that central venous catheter‐related thrombosis and infection are associated, 43 haemato‐oncological patients with an internal jugular vein catheter underwent ultrasound screening for thrombosis every 4 d. Catheter‐related thrombosis was detected in 13/43 patients (30%). Catheter‐related infection, as defined by the U.S. Hospital Infection Control Practices Advisory Committee, was found in 14/43 patients (33%) with colonization of the catheter in two patients, exit site infection in eight patients and catheter‐related bloodstream infection in four patients. Catheter‐related thrombosis and catheter‐related infection coincided in 12 patients and were significantly correlated (Fisher's exact test, P < 0·0001). Detection of thrombosis indicated a catheter‐related infection with a superior sensitivity (86%vs 57%) and an equivalent specificity (97%) compared with the presence of clinical signs (erythema, tenderness, warmth or swelling). Neutropenia, which occurred in 32 patients, was found in 13/14 patients (93%) with a catheter‐related infection and, therefore, seemed to be an important covariate for the development of a catheter‐related infection. This study showed a close correlation between catheter‐related thrombosis and infection. Ultrasound screening for thrombosis was helpful for detecting catheter‐related infection. These findings could be clinically useful for the handling of central venous catheters in patients with an elevated risk of infectious complications.

BACKGROUND. There has been evidence of a higher incidence of testicular germ cell tumors (GCT) in human immunodeficiency virus (HlV)-seropositive men than in the non HIV-infected male population. Most authors recommend standard therapy for HIV-positive patients with GCT but the immunosuppressive effects of Chemotherapy and/or radiotherapy must be considered.

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Background. Wilms' tumor is rare in adults. The recommended treatments for patients with Stage II adult Wilms' tumor with favorable histology (FH) nephroblastomas are conflicting. Methods. Two patients with Stage II, favorable histology, adult nephroblastomas are described. Current treatment modalities are discussed and the literature is reviewed. Results. The first patient, a 52‐year‐old woman, probably had a late local relapse of a Wilms' tumor 21 years after nephrectomy because of a renal tumor originally diagnosed as reticular sarcoma. In this case, a recurring or an extrarenal Wilms' tumor should have been considered. After the tumor was removed, the patient received adjuvant chemotherapy with dactinomycin and vincristine and was disease free 44 months after diagnosis. The Wilms' tumor in the second patient, a 33‐year‐old woman, was discovered accidentally and classified as Stage II/FH based on preoperative biopsy. She was treated with radical nephrectomy and adjuvant chemotherapy with dactinomycin and vincristine. This patient was disease free 24 months after surgery. Conclusions. Surgery and two‐drug chemotherapy with dactinomycin and vincristine is suggested for patients with Stage II adult Wilms' tumor with FH nephroblastomas. Cancer 1995;75:545‐51.