Complex surgical management of hemodialysis vascular access infection caused by Clostridium perfringens
Authors:
MUDr. David Janák, Ph.D.; R. Novotný; M. Slavíková; T. Grus; J. Lindner
Authors‘ workplace:
II. chirurgická klinika-kardiovaskulární chirurgie, 1. lékařská fakulta, Univerzita Karlova v Praze
a Všeobecná fakultní nemocnice v Praze, přednosta: Prof. MUDr. J. Lindner, CSc.
Published in:
Rozhl. Chir., 2014, roč. 93, č. 6, s. 325-327.
Category:
Case Report
Overview
Infection of prosthetic hemodialysis (HD) shunts is one of the most common complications of vascular access in hemodialysis patients. The incidence of anaerobic infection is very rare. In such a case, management of treatment represents a great challenge for the surgeon. We report a complicated case of autologous hemodialysis shunt infected by Clostridium perfringens on the right forearm in a polymorbid female patient with chronic renal failure and myelodysplastic syndrome. The patient has undergone repeated establishment of HD shunt with subsequent polybacterial local infectious complications. Destructive clostridial infection developed at the site of the infectious complications. This very rare complication involving infection by an atypical bacterial agent requires rapid diagnosis and comprehensive multimodal treatment including surgical, antibiotic and supportive therapy. Clinical implications and optimal therapy is not precisely defined in these cases.
Key words:
vascular access – infection – Clostridium perfringens
Sources
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Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2014 Issue 6
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