Chang Celeste Sharon, Thajeb Peterus, Chen Han-Hsiang, Wu Chin-Jen
Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital and Nursing and Management College, Taipei, Taiwan.
Semin Dial. 2005 Jul-Aug;18(4):345-8. doi: 10.1111/j.1525-139X.2005.18323.x.
A patient with newly diagnosed end-stage renal disease (ESRD) received a femoral catheter for hemodialysis (HD). Shortly thereafter he developed fever, and blood cultures grew methicillin-resistant Staphylococcus aureus. The catheter was removed and the patient was treated with both vancomycin and rifampin; however, blood culture positivity persisted. The cerebrospinal fluid showed sterile meningitis. Subsequent imaging studies demonstrated aortic valve endocarditis and multiple mycotic aneurysms that appeared to include the intra- and extracranial vessels. The patient eventually died from sepsis. This case illustrates the aggressive and invasive nature of systemic infection with S. aureus and underscores the high morbidity and mortality associated with infections related to HD catheters.
一名新诊断为终末期肾病（ESRD）的患者接受了用于血液透析（HD）的股静脉导管置入术。此后不久，他出现发热，血培养结果显示为耐甲氧西林金黄色葡萄球菌。导管被拔除，患者接受了万古霉素和利福平治疗；然而，血培养仍持续呈阳性。脑脊液检查显示为无菌性脑膜炎。随后的影像学研究显示主动脉瓣心内膜炎以及多个似乎累及颅内和颅外血管的真菌性动脉瘤。患者最终死于败血症。该病例说明了金黄色葡萄球菌全身感染的侵袭性本质，并强调了与血液透析导管相关感染的高发病率和死亡率。
