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2017 ; 2017
(ä): 9460671
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gab.com Text
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English Wikipedia
Nephrologists Hate the Dialysis Catheters: A Systemic Review of Dialysis Catheter
Associated Infective Endocarditis
#MMPMID28409042
Janga KC
; Sinha A
; Greenberg S
; Sharma K
Case Rep Nephrol
2017[]; 2017
(ä): 9460671
PMID28409042
show ga
A 53-year-old Egyptian female with end stage renal disease, one month after start
of hemodialysis via an internal jugular catheter, presented with fever and
shortness of breath. She developed desquamating vesiculobullous lesions,
widespread on her body. She was in profound septic shock and broad spectrum
antibiotics were started with appropriate fluid replenishment. An echocardiogram
revealed bulky leaflets of the mitral valve with a highly mobile vegetation about
2.3?cm long attached to the anterior leaflet. CT scan of the chest, abdomen, and
pelvis showed bilateral pleural effusions in the chest, with triangular opacities
in the lungs suggestive of infarcts. There was splenomegaly with triangular
hypodensities consistent with splenic infarcts. Blood cultures repeatedly grew
Candida albicans. Despite parenteral antifungal therapy, the patient deteriorated
over the course of 5 days. She died due to a subsequent cardiac arrest. Systemic
review of literature revealed that the rate of infection varies amongst the
various types of accesses, and it is well documented that AV fistulas have a much
less rate of infection in comparison to temporary catheters. All dialysis units
should strive to make a multidisciplinary effort to have a referral process early
on, for access creation, and to avoid catheters associated morbidity.