Calcified Fibrin Sheath Masquerading as Retained Catheter

Abstract

A 46-year-old man who presented with fever and chills had been receiving hemodialysis through a tunneled right internal jugular catheter that had been placed 2 months before presentation. His blood culture grew methicillin-sensitive Staphylococcus aureus; his catheter was removed intact and without incident. Subsequently, a transesophageal echocardiogram showed what appeared to be a catheter in the superior vena cava and the right atrium, with a mobile vegetation attached to the tip (Fig 1). However, a chest radiograph showed no evidence of a retained catheter (Fig 2).