Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Author Reply
Book Review
Brief Communication
Case Report
Case Series
Clinical Case Report
Clinicopathological Conference
Commentary
Corrigendum
Editorial
Editorial – World Kidney Day 2016
Editorial Commentary
Erratum
Foreward
Guidelines
Image in Nephrology
Images in Nephrology
Letter to Editor
Letter to the Editor
Letters to Editor
Literature Review
Notice of Retraction
Obituary
Original Article
Perspective
Research Letter
Retraction Notice
Review
Review Article
Short Review
Special Article
Special Feature
Special Feature - World Kidney Day
Systematic Review
Technical Note
Varia
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Author Reply
Book Review
Brief Communication
Case Report
Case Series
Clinical Case Report
Clinicopathological Conference
Commentary
Corrigendum
Editorial
Editorial – World Kidney Day 2016
Editorial Commentary
Erratum
Foreward
Guidelines
Image in Nephrology
Images in Nephrology
Letter to Editor
Letter to the Editor
Letters to Editor
Literature Review
Notice of Retraction
Obituary
Original Article
Perspective
Research Letter
Retraction Notice
Review
Review Article
Short Review
Special Article
Special Feature
Special Feature - World Kidney Day
Systematic Review
Technical Note
Varia
View/Download PDF

Translate this page into:

Letters to Editor
23 (
5
); 390-390
doi:
10.4103/0971-4065.116328

Catheter related septic inferior vena cava thrombosis

Department of Dialysis, Namikikai Namiki Clinic,, Japan
Department of Emergency Medicine, Nagoya Ekisaikai Hospital, Japan
Address for correspondence: Dr. A. Tanaka, Dialysis Center, Namikikai Namiki Clinic, Uchidabashi 2-10-22, Minami Ku, Nagoya City, 457-0862, Japan. E-mail: zhangren_at_23@yahoo.co.jp
Licence

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Disclaimer:
This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.

Sir,

Placement of central venous catheter (CVC) is an essential technique in the management of critically ill patients. Central venous access is needed to give drugs that cannot be given by mouth or via a peripheral venous access. We experienced a rare complication with CVC and report its images.

An 80-year-old man was hospitalized with cardiopulmonary arrest in July 2007. Despite our intensive care, his consciousness did not recover. Because ventilator could not be removed, tracheostomy was performed in August. But, he presented high fever. Methicillin-resistant Staphylococcus aureus was detected from tracheal tube and blood culture. Thus, vancomycin (VCM) was administered; the course was complicated by VCM-induced acute kidney injury (AKI). CVC was placed in the inferior vena cava (IVC) via the left femoral vein. In September, abdominal computed tomography (CT) done for investigation of fever source revealed air and thrombosis in IVC [Figure 1]. We diagnosed septic IVC thrombosis and CVC was removed. His general condition and renal function gradually recovered. Finally, gastrostomy was performed and he was transferred to another hospital in May 2008.

Figure 1
Abdominal computed tomography (CT) in September. (a) Abdominal CT slice at the level of catheter tip. (b) Enlarged view of a square. Arrow shows air in inferior vena cava. Arrowheads show not enhanced area by contrast that is indicating thrombosis

CVC, thrombosis, and sepsis are related to each other.[1] CT is useful for the diagnosis.[2] Nephrologists often care for AKI patients with CVC in the intensive care unit. AKI patients are immunocompromised and their prognosis is very poor.[3] Although rare, it is important to consider the possibility of catheter-related septic IVC thrombosis.

References

  1. , , , , , , . Central vein catheter-related thrombosis in intensive care patients: Incidence, risks factors, and relationship with catheter-related sepsis. Chest. 1998;114:207-13.
    [Google Scholar]
  2. , , , , , . CT diagnosis of catheter-induced septic thrombus of vena cava. J Comput Assist Tomogr. 1990;14:236-8.
    [Google Scholar]
  3. , , , , , . The spectrum of acute renal failure in the intensive care unit compared with that seen in other settings. The Madrid Acute Renal Failure Study Group. Kidney Int Suppl. 1998;66:S16-24.
    [Google Scholar]

    Fulltext Views
    58

    PDF downloads
    33
    View/Download PDF
    Download Citations
    BibTeX
    RIS
    Show Sections