A case of multiple abscesses caused by group G Streptococcus in a long-term dialysis patient

Abstract

A 75-year-old man, who had been on maintenance hemodialysis for 34 years since the age of 41, was admitted to our hospital due to a persistent fever of unknown origin. After a thorough examination, the fever was considered to be caused by purulent arthritis of the knee joints due to beta-hemolytic group G Streptococcus. Although subsequent antibiotic therapies and surgical treatments were performed, the pyogenic arthritis spread to multiple joints, and the patient eventually died of septicemia. Pathological autopsy revealed that there was multiple abscess formation at sites close to dialysis-related amyloid deposits, suggesting that the long-term dialysis exacerbated the infectious condition. Infections are a frequent cause of hospitalization and death in dialysis patients, and there is concern about an increase in various infectious diseases with the aging of the population. When a patient on long-term dialysis presents with fever of unknown origin, as in the case reported here, differential diagnosis should be made with consideration of infection of soft tissues, especially joints.