혈액투석 도관과 관련된 다발성 폐렴을 동반한 우심방 거대 감염성 혈전증

There has been an increase in the use of central venous catheters for temporary hemodialysis. Infected thrombus of right atrium is a rare but life-threatening complication of the central venous catheterization. A 35-year-old female hemodialysis patient was admitted with fever and dyspnea. She had been inserted tunneled hemodialysis catheter 2 months before. Blood cultures revealed methicillin-resistant Staphylococcus aureus. Chest CT showed multi-focal pneumonia and 4 cm sized huge thrombus in the right atrium. Echocardiography demonstrated same thrombus attached to the catheter tip in the right atrium. The catheter could not be removed because of high risk of pulmonary thromboembolism. Despite intravenous vancomycin treatment, the patient died from esophageal varix bleeding.