Endocardite por Burkholderia cepacia e corpo estranho intracardíaco

Abstract

The authors describe the case of a renal transplant patient who developed late infective endocarditis associated with an intracardiac fragment of a catheter inserted 16 years before. Clinical presentation was anemia of undetermined cause and weight loss. Three blood cultures were positive for Burkholderia cepacia. Transesophageal echocardiography revealed a foreign body in the right atrium and right ventricle, confirmed by computed tomography. The patient underwent intravenous antibiotic therapy, followed by cardiac surgery to remove the foreign body. There were no postoperative complications, with improvement of anemia and stabilization of renal function.

To: Ralstonia pickettii bacteremia in hemodialysis patients: a report of two cases

“…(1) It is worth noting, that the gram-negative agents in venous catheters are a source of endocarditis. (1,2) Persistent neutrophilic leukocytosis and spiked fever despite empirical antibiotic therapy should raise the hypothesis of endocarditis, and an echocardiogram can confirm the vegetation. (1) The authors called attention to major issues about gram-negative endocarditis that can occur in healthcare-associated infections, especially in patients with catheters for hemodialysis.…”

“…(2) In this setting, comments should be made about a Brazilian woman with a renal transplant and a diagnosis of endocarditis by Burkholderia cepacia associated with an intracardiac foreign body. This foreign body was a fragment of a peripherally inserted central catheter positioned 16 years earlier during her treatment in the ICU for a postpartum episode of septicemia and circulatory shock.…”

“…This foreign body was a fragment of a peripherally inserted central catheter positioned 16 years earlier during her treatment in the ICU for a postpartum episode of septicemia and circulatory shock. (2) The cardiac foreign body remained undetected until it was infected by the circulating bacteria, probably because of corticosteroids and muromonabe-Cd3 (OKT3) utilization after her renal transplant. (2) The catheter fragment detected by imaging studies was removed by a cardiotomy procedure.…”

“…(2) The cardiac foreign body remained undetected until it was infected by the circulating bacteria, probably because of corticosteroids and muromonabe-Cd3 (OKT3) utilization after her renal transplant. (2) The catheter fragment detected by imaging studies was removed by a cardiotomy procedure. The 40-year-old woman was treated with a combination of trimethoprim and sulfamethoxazole, considered the first option for her treatment in accordance with the antibiotic sensitivity test.…”

“…The 40-year-old woman was treated with a combination of trimethoprim and sulfamethoxazole, considered the first option for her treatment in accordance with the antibiotic sensitivity test. (2) …”