Huge Infected Thrombus of Right Atrium Related to Hemodialysis Catheter

Korean Journal of Nephrology 2009;28(5):514-518.

Bo Hee Lee, M.D.1, Hyun Gyung Kim, M.D.1, Ja Young Lee, M.D.1, Bong Koo Kang, M.D.1, Eui Sung Chung, M.D.1, Kwang Il Seo, M.D.1, Jin Hee No, M.D.1, Yoo Dong Won, M.D.2, Young Soo Kim, M.D.1, Sun Ae Yoon, M.D.1 and Young Ok Kim, M.D.1

Department of Internal Medicine¹
Radiology²
College of Medicine, The Catholic University of Korea, Seoul, Korea

증례 : 혈액투석 도관과 관련된 다발성 폐렴을 동반한 우심방 거대 감염성 혈전증

이보희1, 김현경1, 이자영1, 강봉구1, 정의성1, 서광일1, 노진희1, 원유동2, 김영수1, 윤선애1, 김영옥1

가톨릭대학교 의과대학 내과학교실1, 방사선과학교실2

Abstract

There has been an increase in the use of central venous catheters for temporary hemodialysis. Infected thrombus of right atrium is a rare but life-threatening complication of the central venous catheterization. A 35-year-old female hemodialysis patient was admitted with fever and dyspnea. She had been inserted tunneled hemodialysis catheter 2 months before. Blood cultures revealed methicillin- resistant Staphylococcus aureus. Chest CT showed multi-focal pneumonia and 4 cm sized huge thrombus in the right atrium. Echocardiography demonstrated same thrombus attached to the catheter tip in the right atrium. The catheter could not be removed because of high risk of pulmonary thromboembolism. Despite intravenous vancomycin treatment, the patient died from esophageal varix bleeding.

Key Words: Thrombosis, Catheter-related infection, Hemodialysis