A Case of a Home Hemodialysis Patient With Infective Endocarditis Complicated by Cerebral Infarction and Septic Pulmonary Embolism, Most Likely Caused by Frequent Shunt Punctures

Abstract

We report a case of home hemodialysis with infectious endocarditis complicated by cerebral infarction and septic pulmonary embolism, most likely due to frequent shunt punctures. The patient, a 52-year-old man, was introduced to hemodialysis at our hospital 11 years ago due to reduced renal function caused by polycystic kidney disease and was transferred to home hemodialysis in the same year. Fever and general weakness appeared four days before he was urgently admitted to our department. Two blood culture sets revealed methicillin-susceptible Staphylococcus aureus (MSSA), brain MRI revealed multiple cerebral infarctions, and transesophageal echocardiography revealed infective endocarditis. The patient was transferred to the cardiology department of an affiliated hospital, treated with antimicrobials (for a total of 58 days), and discharged home on the 63rd day after admission. Frequent shunt punctures were considered to be the cause of the bloodstream infection leading to multiple complications.