Journal
HAEMOPHILIA
Volume 7, Issue 5, Pages 507-510Publisher
BLACKWELL SCIENCE LTD
DOI: 10.1046/j.1365-2516.2001.00556.x
Keywords
bacterial endocarditis; central venous catheters; haemophilia B; needle phobia; pulmonary emboli
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The use of central venous catheters may be complicated by thrombosis and infection. We report a case of a needle-phobic 5-year-old boy with factor IX deficiency, in whom a portacath was inserted owing to poor compliance with prophylactic treatment. Within a week, he developed a Staphylococcus aureus line infection that was treated with a 2-week course of intravenous antibiotics. One month later he presented with nonspecific symptoms and blood cultures again grew S. aureus. An echocardiogram revealed a large vegetation adherent to the tricuspid valve, confirming the diagnosis of bacterial endocarditis. His clinical course was further complicated by the development of pulmonary emboli. Medical treatment with intravenous antibiotics led to a successful resolution of the endocarditis and pulmonary emboli with a favourable long-term outcome.
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