# Successful Non-surgical Management of an Infected Femoral Pseudoaneurysm and Metastatic Septic Arthritis Following Percutaneous Coronary Intervention in a Hemodialysis Patient

## TL;DR

A hemodialysis patient with severe infections after a heart procedure was successfully treated with antibiotics alone, avoiding surgery.

## Contribution

Demonstrates that non-surgical antibiotic treatment can effectively resolve severe infections in high-risk hemodialysis patients.

## Key findings

- A 68-year-old hemodialysis patient's MRSA infections resolved with six weeks of intravenous vancomycin.
- Non-surgical management was successful due to prompt response and close monitoring.
- This case challenges the traditional need for surgery in such infections for high-risk patients.

## Abstract

Infectious complications following percutaneous coronary intervention (PCI) are uncommon but potentially devastating, particularly in hemodialysis patients who experience immunosuppression and elevated methicillin-resistant Staphylococcus aureus (MRSA) colonization rates. We present the case of a 68-year-old woman on hemodialysis who developed an MRSA-infected femoral pseudoaneurysm and contralateral septic shoulder arthritis five days after femoral-access PCI. Despite both conditions traditionally warranting surgical intervention, conservative management with six weeks of targeted intravenous vancomycin therapy achieved complete resolution. This case demonstrates the rapid progression potential of severe infections in immunocompromised hemodialysis patients and highlights the efficacy of antibiotic therapy alone in carefully selected high-surgical-risk patients. Success factors included prompt clinical response, contained infection, and comprehensive clinical and radiological monitoring.