Intracardiac infections due to coagulase-negative Staphylococcus associated with Hickman catheters

Three bone marrow transplant recipients experienced right-sided intracardiac infection due to coagulase-negative Staphylococcus infection associated with Hickman catheter use. In each case, multiple blood cultures yielded coagulase-negative Staphylococcus organisms, and echocardiography demonstrated mass lesions or vegetations in the right atrium. Two patients appeared to have infected intracardiac thrombi without definite valvular involvement, whereas one had both an atrial mass and a tricuspid valve vegetation. All patients were treated with catheter removal and 4 weeks of antibiotic therapy, and one patient required cardiac surgery after failure of antibiotic therapy and an apparent paradoxic embolus to the central nervous system. Intracardiac infection is a rare but potentially fatal complication of Hickman catheter use. Echocardiography may be useful in establishing the diagnosis in suspected cases.