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Reminder of important clinical lesson
Case report
Methicillin-sensitive Staphylococcusaureus bacterial endarteritis associated with vascular closure device
  1. Rosa Alves1,
  2. Tiago Judas1,
  3. João Valença Vieira2 and
  4. Francisca Delerue1
  1. 1Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal
  2. 2Deparment of Vascular Surgery, Hospital Garcia de Orta, Almada, Portugal
  1. Correspondence to Dr Francisca Delerue; pedro.azevedo{at}hgo.min-saude.pt

Abstract

Percutaneous endovascular procedures (PEPs) are increasingly common in clinical practice. Percutaneous closure devices (PCD) ensure safe and immediate haemostasis, reducing the length of hospitalisation and improving patient comfort. Infectious complications are rare. We present the case of a 65-year-old man who was admitted to hospital because of fever and weight loss. He had a history of carotid arterial disease, having been submitted to a PEP 3 weeks before. On admission, he presented feverishly. Anaemia and elevated inflammatory parameters were detected on basic chemistry. Blood cultures isolated methicillin-sensitive Staphylococcus aureus and antibiotic therapy was started. He maintained fever and developed signs of right lower limb ischemia. Bacterial endocarditis was ruled out. Positron emission tomography (PET)-scan revealed inflammatory activity involving the right femoral artery (RFA). Bacterial femoral endarteritis was confirmed on surgical exploration, which documented the presence of infected PCD and occlusion of RFA. After surgery, apyrexia and improvement of ischaemic signs were achieved.

  • nosocomial infections
  • vascular surgery
  • ultrasonography

https://doi.org/10.1136/bcr-2019-232885

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    Footnotes

    • Contributors RA and TJ were the internists responsible for the patient during their hospitalisation and were responsible for the elaboration of the clinical history and literature review of the article. JVV was responsible for reviewing the article regarding to the surgical part, as well as the vascular surgeon responsible for the patient. FD, as director of the Department of Internal Medicine, was responsible for the final revision and respective corrections of the submitted article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.