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The patient with a clotted PTFE graft developing fever
1Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Summary
Clotted haemodialysis access grafts can harbor silent infections, leading to bacterial endocarditis. Suspect these grafts as an infection source in dialysis patients with fever, even without local graft site symptoms.
Area of Science:
- Nephrology
- Infectious Diseases
- Cardiology
Background:
- Haemodialysis access graft infections typically present with local symptoms.
- Bacterial endocarditis is a known complication of infected haemodialysis grafts.
Observation:
- This report details a case of bacterial endocarditis stemming from a silent infection within a clotted haemodialysis access graft.
- The graft was non-functional and showed no overt signs of local infection.
Findings:
- Clotted, non-functioning haemodialysis grafts may indicate underlying silent infections.
- These silent infections can lead to serious complications like endocarditis.
Implications:
- Haemodialysis patients presenting with fever, irrespective of local graft site signs, should be evaluated for potential infection in clotted grafts.
- Early suspicion and investigation of clotted grafts can prevent severe complications such as endocarditis.