Nihon Toseki Igakkai Zasshi
Online ISSN : 1883-082X
Print ISSN : 1340-3451
ISSN-L : 1340-3451
Bacterial vegetation detected in arteriovenous graft on vascular ultrasound during MRSA bacteremia assessment in dialysis patient: A case report
Yasuyuki ObariMasami Chin‒KanasakiWataru MurataMomoko TanakaIchiro MoriNahomi Matsumura‒IshimotoMamoru YoshibayashiShogo KuwagataKosuke YamaharaMako Yasuda‒YamaharaYuki Tanaka‒SasakiJunya HoriguchiMiho YoshiokaRyoichi YokoeAkira SugimotoKoshi SawadaNorihisa HosokawaShinji Kume
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2025 Volume 58 Issue 6 Pages 282-287

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Abstract

The patient was an 82‒year‒old man with chronic renal failure due to diabetic nephropathy, who had been receiving outpatient treatment. Following cerebral infarction, his renal function deteriorated further, necessitating the creation of an arteriovenous graft in his right forearm and initiation of hemodialysis. During hospitalization, he developed a fever and was diagnosed with methicillin‒resistant Staphylococcus aureus (MRSA) bacteremia. Despite continued antimicrobial therapy, blood cultures remained persistently positive. Given the high prevalence of infective endocarditis in such cases, repeated echocardiographic evaluations were conducted; however, no valvular vegetations were detected. Initially, no signs of infection, such as erythema, existed around the vascular graft. However, localized erythema near the anastomosis subsequently appeared. Ultimately, vascular ultrasound revealed mobile vegetations attached to the vascular wall, clarifying the infection source. This case highlights the potential utility of vascular ultrasound in diagnosing arteriovenous graft infections.

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© The Japanese Society for Dialysis Therapy
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