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Double-lumen catheter in the right jugular vein induces two sub-endothelial abscesses in an unusual place, the transition between the superior vena cava and the right atrium: a case report.

Lima JK, Lima SR, de Lima AL, Agra CV, Valenti VE, Gomes RL, Rodrigues LM, Correa JA, Raimundo RD, de Abreu LC - Int Arch Med (2014)

Bottom Line: The location that is most affected are the heart valves.There were several emboli to the lung and foot, and the agent was related to Staphylococcus aureus and a double-lumen catheter.An exhaustive review was made, but we found no information about the location of this abscess and the rarity of the event motivating the report of infection.

View Article: PubMed Central - HTML - PubMed

Affiliation: Unidade Acadêmica Ciências da Vida, Universidade Federal de Campina Grande, Cajazeiras, PB, Brasil ; Laboratório de Delineamento de Estudos e Escrita Científica, Departamento de Saúde da Coletividade, Disciplina de Metodologia Científica, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, 09060-650 Santo André, SP, Brazil.

ABSTRACT
Endocarditis is a type of infection that is common in internal medicine wards and in haemodialysis clinics. The location that is most affected are the heart valves. Herein, we report a case of an uncommon abscess, a sub-endothelial abscess between the transition of the superior vena cava and the right atrium. There were several emboli to the lung and foot, and the agent was related to Staphylococcus aureus and a double-lumen catheter. Usually, this type of abscess is located in valves, either the tricuspid valve if related to catheters or injection drug use or the mitral valve if related to other causes. An exhaustive review was made, but we found no information about the location of this abscess and the rarity of the event motivating the report of infection.

No MeSH data available.


Related in: MedlinePlus

Echocardiography showing two images of sub-endothelial abscesses in the transition from the superior vena cava and right atrium.
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Figure 4: Echocardiography showing two images of sub-endothelial abscesses in the transition from the superior vena cava and right atrium.

Mentions: Complementary tests identified an increased leukocyte count with a left shift, Staphylococcus aureus in the blood culture, and hypotransparency of the circular right and across the middle third of the left lung was seen by chest radiography. Transthoracic echocardiography (TTE) identified good ejection fraction, mild tricuspid insufficiency; concentric hypertrophy of the left ventricle, mitral flow compatible with left ventricle relaxation deficit; global and segmental contractility of preserved left ventricle; and mild pericardial effusion, absence of images compatible with vegetation. Due to the suspicion of endocarditis in right trans-oesophageal echocardiography (TEE) was requested, which surprisingly identified two areas of sub-endothelial abscesses in the transition between the superior vena cava and the right atrium. A lung tomography identified numerous lung abscesses. The patient died a few days after the diagnosis.Figure 1 presents hyperaemic and ulcerated lesion in the left lower limb, while Figure 2 indicates an image of chest radiography with areas of opacity and an image of double-lumen CVC for HD implanted in the left jugular vein.We observe in Figure 3 computed tomography of the thorax with pulmonary lesions with air-fluid levels and in Figure 4 we note the echocardiography showing two images of sub-endothelial abscesses in the transition from the superior vena cava and right atrium.


Double-lumen catheter in the right jugular vein induces two sub-endothelial abscesses in an unusual place, the transition between the superior vena cava and the right atrium: a case report.

Lima JK, Lima SR, de Lima AL, Agra CV, Valenti VE, Gomes RL, Rodrigues LM, Correa JA, Raimundo RD, de Abreu LC - Int Arch Med (2014)

Echocardiography showing two images of sub-endothelial abscesses in the transition from the superior vena cava and right atrium.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4125593&req=5

Figure 4: Echocardiography showing two images of sub-endothelial abscesses in the transition from the superior vena cava and right atrium.
Mentions: Complementary tests identified an increased leukocyte count with a left shift, Staphylococcus aureus in the blood culture, and hypotransparency of the circular right and across the middle third of the left lung was seen by chest radiography. Transthoracic echocardiography (TTE) identified good ejection fraction, mild tricuspid insufficiency; concentric hypertrophy of the left ventricle, mitral flow compatible with left ventricle relaxation deficit; global and segmental contractility of preserved left ventricle; and mild pericardial effusion, absence of images compatible with vegetation. Due to the suspicion of endocarditis in right trans-oesophageal echocardiography (TEE) was requested, which surprisingly identified two areas of sub-endothelial abscesses in the transition between the superior vena cava and the right atrium. A lung tomography identified numerous lung abscesses. The patient died a few days after the diagnosis.Figure 1 presents hyperaemic and ulcerated lesion in the left lower limb, while Figure 2 indicates an image of chest radiography with areas of opacity and an image of double-lumen CVC for HD implanted in the left jugular vein.We observe in Figure 3 computed tomography of the thorax with pulmonary lesions with air-fluid levels and in Figure 4 we note the echocardiography showing two images of sub-endothelial abscesses in the transition from the superior vena cava and right atrium.

Bottom Line: The location that is most affected are the heart valves.There were several emboli to the lung and foot, and the agent was related to Staphylococcus aureus and a double-lumen catheter.An exhaustive review was made, but we found no information about the location of this abscess and the rarity of the event motivating the report of infection.

View Article: PubMed Central - HTML - PubMed

Affiliation: Unidade Acadêmica Ciências da Vida, Universidade Federal de Campina Grande, Cajazeiras, PB, Brasil ; Laboratório de Delineamento de Estudos e Escrita Científica, Departamento de Saúde da Coletividade, Disciplina de Metodologia Científica, Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, 09060-650 Santo André, SP, Brazil.

ABSTRACT
Endocarditis is a type of infection that is common in internal medicine wards and in haemodialysis clinics. The location that is most affected are the heart valves. Herein, we report a case of an uncommon abscess, a sub-endothelial abscess between the transition of the superior vena cava and the right atrium. There were several emboli to the lung and foot, and the agent was related to Staphylococcus aureus and a double-lumen catheter. Usually, this type of abscess is located in valves, either the tricuspid valve if related to catheters or injection drug use or the mitral valve if related to other causes. An exhaustive review was made, but we found no information about the location of this abscess and the rarity of the event motivating the report of infection.

No MeSH data available.


Related in: MedlinePlus