AI Article Synopsis
- Metastatic infections can arise from catheter-related bloodstream infections (CRBSI) in dialysis patients, and an unusual case of an infected aneurysm due to CRBSI without prior infective endocarditis is documented.
- A 43-year-old woman developed CRBSI two weeks after undergoing tunneled dialysis catheter (TDC) insertion, which was complicated by persistent infection despite appropriate antibiotic treatment, leading to the removal of the catheter and antibiotic therapy.
- After being discharged, she returned with severe abdominal pain and was found to have a pseudoaneurysm of the aorta, which ultimately ruptured, underscoring the need for extended antibiotic treatment for CRBSI caused by specific pathogens like Pseudomonas to avoid serious complications.
Article Abstract
Metastatic infections can complicate catheter-related blood stream infections (CRBSI) in dialysis dependent patients. However, an infected/septic aneurysm involving the aorta or its branches as a direct complication of CRBSI without an underlying infective endocarditis is not reported so far in the literature. We report a 43-year female, who presented with CRBSI 2 weeks following a tunneled dialysis catheter (TDC) insertion. Due to the lack of defervescence after 72 h of antibiotics given as per the culture sensitivity reports, the TDC was removed. Blood cultures grew Pseudomonas . After a catheter free interval of 4 days, a TDC was reinserted, an antibiotic course was completed, and she was discharged in stable condition. Five days later, she presented with acute abdominal pain and fever. A tender, firm, and pulsatile mass was noted in the hypogastrium with a bruit. Contrast-enhanced CT revealed a pseudoaneurysm of the aorta, and left common iliac artery at the site of origin. She was started on IV antibiotics and planned for an endovascular prosthesis but had a sudden collapse during her hospital stay due to a ruptured aneurysm. CRBSI due to certain pathogens such as Pseudomonas might require prolonged and dual antibiotic therapy to prevent fulminant complications.
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| http://dx.doi.org/10.1177/11297298231192239 | DOI Listing |
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