title: A Rare Case of Fatal Endocarditis and Sepsis Caused by Pseudomonas aeruginosa in a Patient with Chronic Renal Failure.
abstract: Nosocomial catheter-related and Arteriovenous fistula (AV)-related infections are significant concern in patients undergoing haemodialysis. These infections are associated with multiple complications as well as mortality and demands immediate and appropriate management. While coagulase-negative staphylococci, S.aureus, and Escherichia coli are the most common causes of catheter-related infections in haemodialysis patients, such infections caused by Pseudomonas aeruginosa are relatively rare. Here, we present an unusual case of 36-year-old male patient with chronic renal failure, who developed endocarditis and sepsis from Pseudomonas aeruginosa infection of the left hand arteriovenous fistula. The bacteraemia in the present case caused multiple complications including dry gangrene of bilateral lower limbs, stroke, endophthalmitis, left brachial artery thrombosis and vegetations on the interventricular septum and aortic wall. Despite antibiotic treatment, the patient suffered a cardiac arrest and could not be revived.
authors.affiliation: Consultant, Department of Cardiology, Amrita Institute of Medical Sciences (AIMS), Amrita Vishwa Vidyapeetham University , Kochi, Kerala, India .
authors.forename: Manav
authors.initials: M
authors.lastname: Aggarwal
authors.affiliation: Consultant, Department of Cardiology, Amrita Institute of Medical Sciences (AIMS), Amrita Vishwa Vidyapeetham University , Kochi, Kerala, India .
authors.forename: Vikrant
authors.initials: V
authors.lastname: Vijan
authors.affiliation: Consultant, Department of Cardiology, Amrita Institute of Medical Sciences (AIMS), Amrita Vishwa Vidyapeetham University , Kochi, Kerala, India.
authors.forename: Anjith
authors.initials: A
authors.lastname: Vupputuri
authors.affiliation: Technician, Department of Cardiology, Amrita Institute of Medical Sciences (AIMS), Amrita Vishwa Vidyapeetham University , Kochi, Kerala, India .
authors.forename: Sandya
authors.initials: S
authors.lastname: Nandakumar
authors.affiliation: Professor, Department of Cardiology, Amrita Institute of Medical Sciences (AIMS), Amrita Vishwa Vidyapeetham University , Kochi, Kerala, India .
authors.forename: Navin
authors.initials: N
authors.lastname: Mathew
keywords: Arteriovenous fistula infections; Embolectomy; Endophthalmitis; Gangrene