[Peripheral venous catheter-related E. faecalis sepsis with fatal outcome].
METHODS
A 82 year-old man was admitted with a facial Herpes zoster reactivation and a zoster-related meningoencephalitis. He was treated with Aciclovir over a peripheral venous catheter that was placed in the right elbow pit. The meningoencephalitis subsided without neurological deficits, but the patient developed a catheter-associated phlebitis. An oral cephalosporin was prescribed and the patient discharged. After developing a fever and general discomfort he was readmitted to hospital three days later.


METHODS
A 3 × 3 cm abscess in the elbow pit was incised and drained, but no swab or blood cultures were taken. When the patient's condition got worse an echocardiogram was ordered. It showed vegetations on the aortic and mitral valves as well as on the cardiac pacemaker wires.


METHODS
Blood cultures were positive for Enterococcus faecalis. Although a therapy with vancomycin and ampicillin was started, the patient's condition impaired. Surgical valve replacement was initiated, but the patient expired 5 weeks later due to septic multi-organ failure.


CONCLUSIONS
The danger of peripheral venous catheter infections is frequently underrated, early identification of the causing pathogen, sensitivity testing and proper antibiotic treatment are of tremendous importance. Clinical sings of sepsis must under no circumstances be overlooked.
Integriertes Forschungs- und Behandlungszentrum Sepsis und Sepsisfolgen, CSCC, Universitätsklinikum Jena, Jena.
J J
JJ
Frosinski
F M
FM
Brunkhorst
D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D055499:Catheter-Related Infections / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D013293:Enterococcus faecalis; D017809:Fatal Outcome; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D018805:Sepsis / Q000175:diagnosis* / Q000382:microbiology* / Q000517:prevention & control; D017211:Treatment Failure
D000900:Anti-Bacterial Agents