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Ruptured infected aneurysm of the thoracic aorta associated with tunneled dialysis catheter-related methicillin-resistant Staphylococcus aureus bacteremia in a hemodialysis patient

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Abstract

Patients with an indwelling tunneled dialysis catheter (TDC) for hemodialysis access are at a high risk of developing methicillin-resistant Staphylococcus aureus (MRSA) infection. MRSA bacteremia complications rarely include infected aneurysm. Here, we report the first case of an infected thoracic aneurysm associated with TDC-related MRSA bacteremia. An 86-year-old Japanese male with a TDC for hemodialysis access developed TDC-related MRSA bacteremia. Intravenous vancomycin was initiated, and the TDC was removed on day 3. Despite removal of the catheter and initiation of vancomycin treatment, MRSA bacteremia persisted. Chest computed tomography (CT) showed no aneurysm; however, calcification of the thoracic aorta was detected on admission. The patient subsequently developed hemosputum. CT revealed a thoracic aneurysm, which turned out to be caused by MRSA bacteremia. The patient eventually died because of the rupture of the infected aneurysm, as confirmed by autopsy. This report demonstrates TDC management in a patient with TDC-related MRSA bacteremia and the importance of investigating a metastatic infection to a calcified artery if bacteremia persists.

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Acknowledgements

This work was supported by JSPS KAKENHI Grant numbers 16L08698 to KN.

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Authors and Affiliations

  1. Department of Nephrology, Yokosuka Kyosai Hospital, 1-16 Yonegahamadori, Yokosuka, Kanagawa, 238-8558, Japan

    Fumiko Katsuragawa, Megumi Otani, Takaaki Koide, Sakino Nishiyama, Tomoki Yanagi, Azuma Nanamatsu, Shota Aki, Makoto Aoyagi & Hiroyuki Tanaka

  2. Department of Pathology, Graduate School of Medical Sciences, Kyorin University, Mitaka, Japan

    Kiyotaka Nagahama

  3. Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan

    Shotaro Naito, Tatemitsu Rai & Shinichi Uchida

  4. Department of Pathology, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan

    Yukio Tsuura

Authors
  1. Fumiko Katsuragawa
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  2. Kiyotaka Nagahama
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  3. Shotaro Naito
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  4. Yukio Tsuura
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  5. Megumi Otani
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  6. Takaaki Koide
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  7. Sakino Nishiyama
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  8. Tomoki Yanagi
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  9. Azuma Nanamatsu
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  10. Shota Aki
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  11. Makoto Aoyagi
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  12. Hiroyuki Tanaka
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  13. Tatemitsu Rai
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  14. Shinichi Uchida
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Corresponding author

Correspondence to Shotaro Naito.

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The authors have declared that no conflict of interest exists.

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This article does not contain any studies with human participants performed by any of the authors.

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Katsuragawa, F., Nagahama, K., Naito, S. et al. Ruptured infected aneurysm of the thoracic aorta associated with tunneled dialysis catheter-related methicillin-resistant Staphylococcus aureus bacteremia in a hemodialysis patient. CEN Case Rep 7, 325–329 (2018). https://doi.org/10.1007/s13730-018-0352-z

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  • DOI: https://doi.org/10.1007/s13730-018-0352-z

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