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- Title
Central Line Associated Thrombus vs. Superimposed Vegetation in the Setting of Staphylococcus aureus Bacteremia.
- Authors
BALLARD, RICHARD D.; BROCK, JAMES B.; KERUT, EDMUND K.; FOX, ERVIN R.; WOLFE, DOUGLAS; HALL, MICHAEL E.
- Abstract
Superior vena cava (SVC) thrombosis and infection are common complications of indwelling catheters. In patients with bacteremia, it is difficult to differentiate SVC thrombus from infectious vegetation or septic thrombophlebitis based on imaging techniques. Furthermore, treatment strategies and duration of therapy for each complication are debatable and lacking robust clinical data. We present two cases involving patients with recently removed central venous catheters (CVC) who were found to have large echodensities in the SVC by transesophageal echocardiography (TEE). Both patients presented with sepsis from Staphylococcus aureus bacteremia and underwent TEE for the evaluation of cardiac vegetations. It was unclear whether the echodensities represented thrombus, vegetation, or a combination of both. Therefore, six weeks of culture-directed antibiotics and therapeutic anticoagulation were recommended until repeat imaging confirmed resolution of the echodensities. Here we propose a strategy for management of presumed CVC-related SVC thrombus in the setting of sepsis from Staphylococcus aureus bacteremia.
- Subjects
VENOUS thrombosis; SUPERIOR vena cava syndrome; STAPHYLOCOCCUS aureus; BACTEREMIA; VENA cava superior; THROMBOSIS; CENTRAL venous catheters
- Publication
Journal of the Mississippi State Medical Association, 2019, Vol 60, Issue 4, p145
- ISSN
0026-6396
- Publication type
Case Study