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- W2605698921 abstract "Chronic indwelling central venous catheters can result in formation of fibrin sheaths increasing risk of occlusion, thrombosis and infection. Endovascular infection of right-sided heart structures induced by such sheaths is very rare. A 48-year-old woman with end-stage renal disease initially treated for diabetic ketoacidosis developed persistent <i>Staphylococcus epidermidis</i> bacteraemia without an identifiable source. Although transthoracic echocardiography was unremarkable, transoesophageal echocardiography revealed a fibrin sheath and vegetations in superior vena cava–right atrium junction, which was the site of the tip of a central catheter that had been removed 2 months prior, consistent with fibrin sheath-associated endovascular infection. The bacteraemia cleared and clinical improvement was seen with prolonged intravenous vancomycin. In patients with unexplained bacteraemia and history of a central catheter, rare causes of endovascular infections of right-sided heart structures like fibrin sheaths should be considered. These can persist months after catheter removal. Transoesophageal echocardiogram should be used for earlier detection." @default.
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- W2605698921 date "2017-04-17" @default.
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- W2605698921 title "Fibrin sheath-associated endovascular infection of the heart: the Trojan horse of indwelling central venous catheters" @default.
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- W2605698921 doi "https://doi.org/10.1136/bcr-2016-219060" @default.
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