Case Report: Infective endocarditis following arteriovenous graft in a peritoneal dialysis patient

TL;DR

A peritoneal dialysis patient developed severe heart infection after repeated use of an arteriovenous graft, highlighting risks and management challenges in dialysis patients.

Contribution

This case report emphasizes the risk of infective endocarditis in dialysis patients with vascular access devices and underscores the need for early detection and individualized treatment.

Findings

A PD patient developed IE after repeated AVG punctures, caused by Staphylococcus aureus.

The patient required multiple valve replacements and hospitalizations due to recurrent heart failure.

The case highlights the importance of surveillance and timely intervention to improve outcomes in dialysis patients.

Abstract

Infective endocarditis (IE) is a severe and frequently fatal complication in dialysis patients, particularly those with vascular access devices such as arteriovenous grafts (AVGs) or fistulas. We describe the case of a 55-year-old male with end-stage renal disease (ESRD) on peritoneal dialysis (PD), who developed advanced IE following repeated punctures of an AVG. The patient initially presented with fever, erythema, and swelling at the graft site, which progressed to bacteremia due to Staphylococcus aureus. Despite completing a full course of antibiotics and undergoing both mitral and aortic valve replacement, the patient suffered recurrent episodes of acute heart failure requiring repeated hospital admissions. This rare case highlights the substantial risk of IE in dialysis patients with vascular access devices and the importance of early detection and timely intervention. The clinical difficulties and economic strain associated with IE management in this population point to the need for close surveillance, rapid diagnosis, and individualized treatment plans to improve outcomes and control healthcare expenditures.

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