Apsces mozga - retka komplikacija kateter-vezanih infekcija kod bolesnika na hemodijalizi

Tatjana Mirković-Đurđević,Violeta Knežević,Lada Petrović,Dejan Ćelić

doi:10.5937/hpimj1801590k

Tatjana Mirković-Đurđević, Violeta Knežević + Show 2 more

Open Access

https://doi.org/10.5937/hpimj1801590k

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Abstract

Introduction: Vascular approach is one of the main risk factors that causes infections in patients that are treated by hemodialyses. Brain abscess is one of the rarer metastatic complications of dialytic catheter sepsis. Metastatic infections contribute to the increase of morbidity and mortality rates in hemodialytic patients. Case report: A 38 year-old male patient with the case history of hypertension and a rapid progressive glomerulonephritis treated by hemodialyses who developed brain abscess caused by catheter related complication in the region where he had left-sided parenteral ischemic brain stroke. The admitted patient had no subjective symptoms and neurological deficiency, elevated inflammation parameters. No microorganisms were found after the necessary laboratory analyses, puncture point and catheter tip swab tests. Two weeks after hospital admission the patient's condition deteriorated in terms of an increased number of abscess lesions diagnosed by MRI of endocardium, without clinical impairment and increase of inflammation parameters, so the right choice and duration of parenteral antibiotic administration caused brain abscess regression. Conclusions: Albeit brain abscess is a rare complication of the septic state, physicians should have in mind previous brain lesions, especially in immunosuppressed patients.

Highlights

Previous studies have shown that vascular approach is the main risk factor that causes infections in patients treated by hemodialyses
It has been concluded that there is less risk of infections in patients with arteriovenous fistula (AVF) and arteriovenous graft, and that the risk is higher in patients with temporary or permanent catheters [1]
Metastatic infections are present in 5 to 10% of the patients with catheter sepsis and they appear as osteomyelitis, endocarditis, septic arthritis and epidural abscess [2]

Summary

Introduction

Vascular approach is one of the main risk factors that causes infections in patients that are treated by hemodialyses. Brain abscess is one of the rarer metastatic complications of dialytic catheter sepsis. Case report: A 38 year-old male patient with the case history of hypertension and a rapid progressive glomerulonephritis treated by hemodialyses who developed brain abscess caused by catheter related complication in the region where he had left-sided parenteral ischemic brain stroke. Two weeks after hospital admission the patient’s condition deteriorated in terms of an increased number of abscess lesions diagnosed by MRI of endocardium, without clinical impairment and increase of inflammation parameters, so the right choice and duration of parenteral antibiotic administration caused brain abscess regression. Conclusions: Albeit brain abscess is a rare complication of the septic state, physicians should have in mind previous brain lesions, especially in immunosuppressed patients

INTRODUCTION

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