Infectious metastases (e.g., infective endocarditis, epidural abscess, liver & lung abscesses, etc) are unfortunately not uncommon in the ESRD population, particularly in those with in-dwelling catheters. I have personally seen several cases of epidural abscesses as a fellow, a complication which can be neurologically devastating and nearly impossible to treat. Clearly, prevention is the key issue.A small but instructive case series from Kovalik et al in a 1996 issue of JASN reviewed all the cases of dialysis patients with epidural abscess over a 5-year period within the Duke health care system. Of the 10 patients identified, the majority (8) had catheters, 5 of whom with known bacteremia with an attempt to treat the infection with antibiotics alone. The lesson, if you haven't learned it by now: catheter-associated bacteremia virtually always should be treated with a line change, as there are significant risks to doing otherwise.
No comments:
Post a Comment
Renal Fellow Network encourages comments and discussion regarding the posts. Do not post any comments that are commercial or advertising in nature. Posts will be deleted if commercial or advertising comments are made. Internet users commenting on the Renal Fellow Network must post information which is true and correct to their knowledge. Sources to health/medical claims must be provided when relevant. Moderators reserve the right to erase, without notification, any comment they would judge inappropriate.