Panhemispheric infarction: a complication of cuffed catheter.
The need for reliable vascular access remains the Achilles heel of hemodialysis. Complications of vascular access are a leading cause of morbidity and mortality in patients who undergo hemodialysis, especially in those patients with end-stage renal disease. Among methods of vascular access, arteriovenous fistulae have the lowest rate of infection and should be the access of choice when vascular anatomy permits. Also, the incidence of staphylococcal infections in patients infected with human immunodeficiency virus is increasing. To emphasize the need to use arteriovenous fistula access for hemodialysis whenever possible, we report the case of a patient with end-stage renal disease and human immunodeficiency virus infection who died as a result of panhemispheric infarction and uncal herniation as a result of fulminant staphylococcal bacteremia caused by central venous catheter sepsis.
Agraharkar
Mahendra
M
Department of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX 77555-0562, USA. mlagraha@utmb.edu
Gokhale
Sumita
S
Cinclair
Robert
R
Patel
Jignesh
J
Gupta
Rajiv
R
D000328:Adult; D016470:Bacteremia / Q000209:etiology* / Q000473:pathology; D020520:Brain Infarction / Q000209:etiology* / Q000473:pathology; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D006435:Renal Dialysis / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000209:etiology* / Q000473:pathology