title: Catheter-related right-sided endocarditis in bone marrow transplant recipients.
abstract: Bone marrow transplant recipients are at increased risk of severe central venous catheter-related septicemias that may be complicated by endocardial infection. In view of this, we prospectively evaluated 141 consecutive patients receiving allogeneic or autologous bone marrow infusion. Seven (5%) of 141 patients developed eight episodes of a clinical syndrome compatible with catheter-related right-sided infective endocarditis; this diagnosis was confirmed at autopsy in two patients who died. Staphylococcus epidermidis was the most frequent isolate (four cases). Other offending pathogens were, in one case each, Enterococcus faecalis, Corynebacterium jeikeium, Pseudomonas alcaligenes, and Achromobacter xylosoxidans plus Candida species. Three- to 7-week courses of antibacterial therapy were associated with a favorable outcome in six of the seven cases. Infective endocarditis may be a complication of the use of central venous catheters and should be actively sought in septicemic bone marrow transplant recipients.
authors.affiliation: Dipartimento di Biopatologia Umana, Università La Sapienza, Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Martino
authors.forename: A
authors.initials: A
authors.lastname: Micozzi
authors.forename: M
authors.initials: M
authors.lastname: Venditti
authors.forename: G
authors.initials: G
authors.lastname: Gentile
authors.forename: C
authors.initials: C
authors.lastname: Girmenia
authors.forename: R
authors.initials: R
authors.lastname: Raccah
authors.forename: S
authors.initials: S
authors.lastname: Santilli
authors.forename: N
authors.initials: N
authors.lastname: Alessandri
authors.forename: F
authors.initials: F
authors.lastname: Mandelli
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D004697:Endocarditis, Bacterial / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000150:complications* / Q000209:etiology