A Case Report of Crohn's Disease Complicating with Brain Abscesses and Splenic Abscesses caused by Infection of Central Venous Catheter and Subcutaneal Port

Abstract

A 40-year-old man with Crohn's ileocolitis and undergoing home parenteral nutrition (HPN) using an implanted port due to malnutrition and intractable enterocutaneus fistula was referred for hospitalization due to loss of consciousness after 1 week of a high-grade fever. Cerebrospinal fluid examination showed bacterial meningitis and positive blood culture of gram-positive cocci necessitating immediate removal of the implanted port for suspected catheter sepsis. CT and magnetic resonance imaging showed brain and splenic abscesses. Because of a severe hemorrhagic tendency, surgical intervention was not selected. After the catheter was removed and intravenous antibiotics administered, his general condition and brain and splenic abscesses improved with conservative therapy alone. Cultures of blood, spinal fluid, and the catheter tip were all positive for Staphylococcus aureus. Both brain and splenic abscess are a rare complications of catheter-related sepsis, but it is important that appropriate instructions on HPN complications and measures be provided to prevent these severe complications