Management of the Bacterial Endocarditis of the Native Aortic Valve in a Patient with Chronic Hemodialysis
Author(s): Arjana Strakosha, Nevi Pasko, Elvana Rista, Vilma Cadri, Blerim Arapi, Jorida Djamandi, Ali Guy, Juna Musa
Infective endocarditis is one of the most important complications in hemodialysis patient due to vascular access, mainly in patients with central venous catheter (CVC) and arteriovenous (AV) graft. Infective endocarditis is associated with a high mortality for this category of patients. We present the case of a 56-year old male in hemodialysis treatment since 2015. He had a thrombosis of the native arteriovenous fistulas, which was corrected using an arteriovenous graft prosthesis. After a period of several months, the graft was thrombosed and a percutaneous thrombectomy of thrombosed hemodialysis graft was performed. Three months later the patient was identified with an infection of the graft, and also developed secondary bacteremic staphylococcal pneumonia and further aortic valve endocarditis. Infective endocarditis is a complex disease with a high mortality. A particular attention to this complication is required for hemodialysis patients who are using an AV graft because immediate diagnosis and treatment it is associated with a successful management of the infective endocarditis complication. Prevention strategies on following strict asepsis protocols, from placing the access to its manipulation during dialysis sessions, would lead to a significant reduction of this life-threatening complication in patients with hemodialysis.