2022 Volume 58 Issue 1 Pages 45-51
The patient was a 19-year-old female with allied disorders of Hirschsprung’s disease (isolated hypoganglionosis) and a high jejunostomy. She had been receiving home parenteral nutrition using a central venous port system. She was admitted with chest pain around the central venous port, and a diagnosis of catheter-related bloodstream infection was made. She was treated with antibiotics and central venous port replacement. Twelve days after discharge from our hospital, she developed fever, and two sets of her blood cultures showed Staphylococcus aureus, whereas chest CT showed nodular and cavernous lesions with multiple infiltrative shadows in both lungs. The diagnosis of septic pulmonary embolism associated with catheter-related bloodstream infection was made. Antibiotic therapy was initiated to preserve the catheter because the remaining central venous route was limited; however, the central venous catheter was removed because her respiratory condition worsened. The patient’s respiratory condition improved quickly after the removal of the catheter. Blood cultures were confirmed to be negative for the bacterium, and the patient was discharged after central venous port replacement and four weeks of intravenous antibiotic therapy. In this disease, a diagnosis based on chest CT findings and early intervention with appropriate antimicrobial agents are necessary. Here, we report the clinical course of our patient and a review of literature.
