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Multiple metastatic infections in a hemodialysis patient with untunneled internal jugular catheter

Sandeep Peddi1, Rapur Ram, Varalakshmi Devi Boreddy

  • 1Nephrology, SVIMS, Tirupati, India.

Hemodialysis International. International Symposium on Home Hemodialysis
|June 21, 2013
PubMed

Insights

This case study highlights a rare instance of psoas muscle abscess in an end-stage renal disease patient undergoing hemodialysis. The infection likely spread from a dialysis catheter, emphasizing the need for vigilance in managing access-related complications.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Radiology

Background:

  • End-stage renal disease (ESRD) patients on hemodialysis are susceptible to infections.
  • Internal jugular vein catheters are common access points for hemodialysis.

Observation:

  • A patient with ESRD on dialysis presented with fever and multiple metastatic infections.
  • The primary source was identified as a right internal jugular vein catheter.
  • Metastatic infections included a right psoas muscle abscess and a left kidney abscess.

Findings:

  • An arteriovenous communication in a left lung cavity was suspected as the route for metastatic spread.
  • (18)F-fluorodeoxyglucose-positron emission tomography (FDG-PET) scan was utilized to locate the left kidney abscess.
  • Literature review revealed a paucity of cases detailing psoas abscess secondary to hemodialysis access infection.

Implications:

  • This case underscores the potential for severe, disseminated infections originating from hemodialysis access.
  • Highlights the diagnostic utility of FDG-PET in identifying deep-seated abscesses.
  • Suggests increased awareness and monitoring for unusual infectious complications in ESRD patients with dialysis catheters.
Keywords:
Metastatic infectionspositron emission spectroscopypsoas muscle abscessuntunneled internal jugular catheter

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