title: Duodenal perforation by an inferior vena cava filter with staphylococcal bacteremia: a case report.
abstract: BACKGROUND
  Inferior vena cava filter complications can range from dislodgement to perforation. Patients who present with concomitant bacteremia have rarely been reported. Persistent bacteremia usually results from direct bacterial seeding from a source other than perforation of surrounding viscus. It is unclear if the risk of perforation is higher in patients who are bacteremic due to other causes.
  
  
  METHODS
  We report an interesting case of a 67-year-old white woman who presented with fever, chills, and right upper quadrant abdominal pain. Her blood cultures were positive for methicillin-sensitive Staphylococcus aureus with no obvious source. Upon further investigation, she was found to have an inferior vena cava filter perforating her duodenum. The cause of her abdominal pain was explained by the inferior vena cava filter penetrating the duodenum; however, the source of bacteremia could not be ascertained. The inferior vena cava filter was removed successfully, and she was discharged on an intravenous antibiotic. Her symptoms resolved soon after the filter was removed.
  
  
  CONCLUSIONS
  The use of inferior vena cava filters has increased significantly in recent years. This is likely due to their wider availability and safer placement techniques. With increasing use, the complications arising from these filters have been on the rise as well. It is very important for clinicians to be aware of these complications to avoid delays in diagnosis and patient care.
authors.affiliation: Department of Medicine, Albany Medical Center, 47 New Scotland Avenue, Mail Code 17, Albany, NY, 12208, USA. pokhars@mail.amc.edu.
authors.forename: Sunil
authors.initials: S
authors.lastname: Pokharel
authors.affiliation: Department of Gastroenterology, Albany Medical Center, 47 New Scotland Avenue, Mail Code 48, Albany, NY, 12208, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Bartholomew
authors.affiliation: Department of Medicine, Albany Medical Center, 47 New Scotland Avenue, Mail Code 17, Albany, NY, 12208, USA.
authors.forename: Zing
authors.initials: Z
authors.lastname: Zau
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000150:complications*; D004378:Duodenal Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D004386:Duodenum / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000209:etiology*; D011655:Pulmonary Embolism / Q000628:therapy*; D013203:Staphylococcal Infections / Q000150:complications*; D014057:Tomography, X-Ray Computed; D016306:Vena Cava Filters / Q000009:adverse effects*
keywords: Bacteremia; Inferior vena cava; Perforation