Infectious complications of old nonfunctioning arteriovenous grafts in renal transplant recipients: a case series.
Am J Kidney Dis
; 40(4): 832-6, 2002 Oct.
Article
en En
| MEDLINE
| ID: mdl-12324920
Occult infection of old nonfunctioning arteriovenous grafts (AVGs) is frequent among hemodialysis patients. It is a risk factor for bacteremia and serious AVG-related infection. Immunocompromised patients are at increased risk of dissemination of occult AVG infection. We present a series of five renal transplant recipients who developed acute life-threatening infections that originated in their old nonfunctioning AVGs. Their presenting symptoms were noticeably varied. In two patients, infection of the AVG was characterized by local physical signs of infection around the AVG. In three patients, no physical signs of AVG infection were detected by physical examination. Among these, two presented with bacteremia, and one presented with failure to thrive. Detection of AVG infection in the absence of local signs of infection requires a high index of suspicion. Surgical resection and antimicrobial treatment led to a complete cure in four of these patients. One patient developed recurrent bacterial endocarditis and died. Old nonfunctioning AVGs are potential sources of serious infection in renal transplant recipients. Renal transplant recipients with old nonfunctioning AVGs who present with unexplained bacteremia, fever of unknown origin, or failure to thrive should be investigated for occult AVG infection. Screening for occult infection of the old nonfunctioning AVG may be considered before kidney transplantation, especially if the candidate gives a history of previous bacteremia or fever of unknown origin.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Infecciones Estafilocócicas
/
Derivación Arteriovenosa Quirúrgica
/
Trasplante de Riñón
/
Infecciones Relacionadas con Prótesis
/
Oclusión de Injerto Vascular
Tipo de estudio:
Diagnostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Am J Kidney Dis
Año:
2002
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos