Septic pulmonary embolism associated with an indwelling hemodialysis catheter

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  • Ishiwatari Ayumi
    The Center of Nephrology at Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital
  • Hasegawa Jumpei
    The Center of Nephrology at Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital
  • Saito Takako
    The Center of Nephrology at Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital
  • Inoue Tyuya
    The Center of Nephrology at Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital
  • Kamei Yuiko
    The Center of Nephrology at Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital
  • Yamada Kei
    The Center of Nephrology at Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital
  • Nakayama Issei
    The Center of Nephrology at Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital
  • Ogawa Toshie
    The Center of Nephrology at Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital
  • Abe Yasutomo
    The Center of Nephrology at Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital
  • Endo Mariko
    The Center of Nephrology at Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital
  • Wakai Sachiko
    The Center of Nephrology at Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital

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Other Title
  • 敗血症性肺塞栓症をきたしたカフ型カテーテル挿入透析患者の1例
  • 症例報告 敗血症性肺塞栓症をきたしたカフ型カテーテル挿入透析患者の1例
  • ショウレイ ホウコク ハイケツショウセイ ハイ ソクセンショウ オ キタシタ カフガタ カテーテル ソウニュウ トウセキ カンジャ ノ 1レイ

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Abstract

We present an unusual pulmonary complication associated with a dialysis catheter. A 49-year-old female was admitted to our hospital with pain in the lower limbs. Hemodialysis was initiated at the age of 32 following acute kidney injury of unknown etiology. She had vascular graft infections at the ages of 44 and 47. A permanent cuffed dialysis catheter was inserted via the right internal jugular vein, and she developed Staphylococcus aureus bacteremia and left sacroiliac arthritis one year after the catheter insertion. At the age of 49, she was hospitalized for a detailed examination because of pain in the lower limbs. Chest computed tomography showed multiple nodular lesions with interior cavitation and feeding vessel signs ; therefore, we diagnosed septic pulmonary embolism (SPE). Magnetic resonance imaging revealed right sacral osteomyelitis and abscessation. The source of this may have been catheter-related bloodstream infection. Blood cultures taken on admission were negative because ceftriaxone had already been administered. The administration of tazobactam/piperacillin hydrate and vancomycin resolved the symptoms, and shadows in the lung field and right sacral osteomyelitis decreased. We should recognize SPE as a complication of bacteremia and sepsis in hemodialysis patients.

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