[Septic pulmonary embolism in patients on chronic hemodialysis with Staphylococcus aureus bacteremia]

Twenty-one cases of septic pulmonary embolism were selected from a series of 76 patients on chronic haemodialysis diagnosed of S. aureus bacteremia. Ninety percent of patients underwent dialysis through an arteriovenous fistula and 10% by means of a prosthetic access. The most common symptoms were fever (100%), pleuritic pain (66%) and productive cough (55%); twenty-four percent of patients had inflammatory signs at vascular accesses. All patients had some symptoms indicative of pulmonary pathology and all of them had positive blood cultures and findings in the chest X-ray. The clinical course was favourable in 100% of cases. Accesses were lost only in the two cases with prosthetic material. The diagnosis was obtained by chest X-ray and blood cultures. Other more sophisticated tests did not improve the diagnostic yielding.