Evans Ieuan E S, Haqqani Haris, Smith Daniel, Reid David W
Adult Cystic Fibrosis Centre The Prince Charles Hospital Brisbane Queensland Australia.
Faculty of Medicine University of Queensland Brisbane Queensland Australia.
Respirol Case Rep. 2024 Dec 10;12(12):e70087. doi: 10.1002/rcr2.70087. eCollection 2024 Dec.
Totally implantable venous access devices (TIVADs) are frequently used in people with cystic fibrosis as a means of securing consistent vascular access, particularly in the context of severe disease and microbial colonization. Infection of TIVADs is not uncommon and typically associated with coagulase negative staphylococci, though infection with other organisms does occur too. We report on the first case of a TIVAD infection caused by in person with cystic fibrosis. The TIVAD infection was complicated by a bacteraemia and an associated intracardiac infected thrombus at the superior atriocaval junction. We explore the complex management decisions surrounding the removal of the TIVAD and prolonged antibiotic treatment, with treatment ultimately resulting in a good outcome and full recovery. The case helps to serve as a timely reminder of requirement to review the necessity to retain TIVAD in the era of CFTR modulator therapy and associated improved health outcomes being experienced.
完全植入式静脉通路装置(TIVADs)常用于囊性纤维化患者,作为确保持续血管通路的一种手段,尤其是在严重疾病和微生物定植的情况下。TIVADs感染并不罕见,通常与凝固酶阴性葡萄球菌有关,不过也确实会发生由其他微生物引起的感染。我们报告了首例由[此处原文缺失感染微生物名称]引起的囊性纤维化患者TIVAD感染病例。该TIVAD感染并发菌血症以及上腔静脉-心房交界处的心脏内感染性血栓。我们探讨了围绕TIVAD移除和延长抗生素治疗的复杂管理决策,最终治疗取得了良好效果,患者完全康复。该病例及时提醒人们,在CFTR调节剂治疗时代以及相关健康状况改善的背景下,需要重新审视保留TIVAD的必要性。