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Year : 2021  |  Volume : 31  |  Issue : 1  |  Page : 54-56

Fracture Embolism of In-situ Guidewire–Bewildering Aetiology of Protracted Pyrexia in a Patient with End Stage Renal Disease!

Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Dr. Raja Ramachandran
Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_330_19

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Guidewire embolism during venous access for haemodialysis is not uncommon yet potentially avoidable iatrogenic complication. Unrecognised, long-standing in-situ guidewire may predispose to thrombosis and become a nidus for infection. This entity should always be borne in mind and considered as one of the differentials of unexplained pyrexia in patient on maintenance haemodialysis. In this context, we report a patient on maintenance dialysis who presented with fever of 6 weeks duration with no localising history and failed response to empirical antibiotics. On imaging, he was detected to have in-situ guidewire with fracture embolism into inferior vena cava and right external iliac vein and soon patient became afebrile following guidewire retrieval using gooseneck snare device, thereby retrospectively confirming causality.


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Indian Journal of Nephrology
Published by Wolters Kluwer - Medknow
Online since 20th Sept '07