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Volume 10,Issue 1

Fall 2025

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25 July 2022

A Case of a Home Hemodialysis Patient With Infective  Endocarditis Complicated by Cerebral Infarction and  Septic Pulmonary Embolism, Most Likely Caused by  Frequent Shunt Punctures

Tomohiro Ikezawa1* Sho Obara1 Yumi Yokoyama1 Hisashi Furukawa1 Junna Yokota1 Satoru Kaneko1 Ryu Hagihara1 Daiki Kawasaki1 Daichi Fukaya1 Tatuo Kondou1 Kei Sugiyama1 Yuto Itou1 Hiroaki Amano1 Kouji Tomori1 Yusuke Watanabe1 Tutomu Inoue1 Hirokazu Okada1
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1 Department of Nephrology, Saitama Medical University Hospital, 38 Morohongo, Moroyama, Iruma, Saitama, 350-0451, Japan
© 2022 by the Author(s). Licensee Whioce Publishing, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

We report a case of home hemodialysis with infectious endocarditis  complicated by cerebral infarction and septic pulmonary embolism,  most likely due to frequent shunt punctures. The patient, a 52-year-old  man, was introduced to hemodialysis at our hospital 11 years ago due  to reduced renal function caused by polycystic kidney disease and was  transferred to home hemodialysis in the same year. Fever and general  weakness appeared four days before he was urgently admitted to our  department. Two blood culture sets revealed methicillin-susceptible  Staphylococcus aureus (MSSA), brain MRI revealed multiple cerebral  infarctions, and transesophageal echocardiography revealed infective  endocarditis. The patient was transferred to the cardiology department  of an affiliated hospital, treated with antimicrobials (for a total of 58  days), and discharged home on the 63rd day after admission. Frequent  shunt punctures were considered to be the cause of the bloodstream  infection leading to multiple complications.

Keywords
Hemodialysis
Infective endocarditis
Pulmonary embolism
Cerebral infarction
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Conflict of interest
The authors declare no conflict of interest.
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