Zheng Yiyi,Liu Yi,Guo Jiaowei. A clinical analysis of patients with infective endocarditic in hemodialysis[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2020, 50(1): 65-67.
Abstract：Objective: To analyze the clinical features and outcomes of hemodialysis (HD) patients complicated with infective endocarditis (IE). Methods: Clinical data of 460 ESRD patients with hemodialysis admitted to the First Affiliated Hospital of Wenzhou Medical University from January 2013 to December 2017 were collected. Results: There were 9 patients with IE, with an average age of 58.2±13.8 years old and five males. The vascular access was long-term central venous catheter with an average dialysis time of 20 months. Fever was the common symptom (100%). Complications occurred in 6 cases: mainly cerebral infarction, heart failure and cerebral hemorrhage. All patients underwent blood culture examination, 7 cases were positive and the main bacteria ware staphylococcus (71.4%). Thoracic echocardiography (TTE) was used in 7 patients, Tran Esophageal Echocardiography (TEE) in 1 patient, and both TTE and TEE examined in 1 patient. Vegetations were found in nine patients. The most common involvement was mitral valve (5/9), followed by tricuspid valve (2/9). Eight patients were treated conservatively. One underwent surgical treatment. Four patients were discharged after improvement and five patients were discharge automatically. Conclusion: Hemodialysis with CVC is a risk factor of IE. Hemodialysis patients, especially dialysating with CVC should be considered infectious endocarditis if they have fever. Echocardiography and blood culture are two main methods for clarifying the diagnosis.
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