Endocarditis with Permanent Hemodialysis Tunneled Catheter: A Severe and Multidisciplinary SituationMaaoui D1,2*, Jerbi M1,2, Gaied H1, Mannai K1, Kallel H1, Harzallah A1, Trabelsi R1, Ghabi H1, Kaaroud H1, Ghoucha R1, Elyounsi F1, Hamida FB1,2 and Abdallah TB1
- Corresponding Author:
- Maaoui D
Internal Medicine Department
Hospital Charles Nicole, Tunis, Tunisia
E-mail: [email protected]
Received date: April 26, 2017; Accepted date: May 02, 2017; Published date: May 09, 2017
Citation: Maaoui D, Jerbi M, Gaied H, Mannai K, Kallel H, et al. (2017) Endocarditis with Permanent Hemodialysis Tunneled Catheter: A Severe and Multidisciplinary Situation. Int J Neurorehabilitation 4:267. doi:10.4172/2376-0281.1000267
Copyright: © 2017 Maaoui D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Tunnelled catheter endocarditis is a frequent and sever situation among hemodialysis patients. The management should be fast and multidisciplinary. Case report: We report the case of a 36 year old woman with a history of systemic erythematous lupus, discovered at the age of twenty. She profited from a tunneled catheter because of exhaustion of her venous capital. One year later, the patient had an endocarditis of the tricuspid valve. An echocardiogram demonstrated mobile and friable 8 mm vegetation in the tricuspid valve. Blood cultures were positive for pseudomonas and klebsiella. The catheter was removed at the fifth day of the infection. The patient received antibiotic treatment which was changed on several occasions in front of multiresistant strains. Ten days later, the blood culture showed Candida albicans. The echocardiogram demonstrated an increase of the size of the vegetation to 15 mm. A chest CT carried out in front of a respiratory distress showed pulmonary septic emboli. Tricuspid valve replacement was performed. Culture of native valve was positive for multiresistant candida famata. The patient developed a pulmonary embolism causing her death. Discussion: Endocarditis with permanent catheter is a severe situation with high mortality and poor prognosis among hemodialysis patients. Immune suppression due to a renal failure and auto immune disease can support the development of multiresistant strains difficult to treat. Conclusion: Endocarditis on tunneled catheter is a serious infection. Nephrologists, cardiologists and infectiologists must collaborate in order to provide adequate therapy.