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The Removal of Central Venous Silicone Rubber Catheters

Robert Chase, MD; Harold A. Kessler, MD
JAMA. 1986;255(15):2022. doi:10.1001/jama.1986.03370150063012.
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To the Editor.—  Complications associated with the use of indwelling right atrial catheters include infection, thrombosis, dislodgement, migration of the catheter tip, subcutaneous catheter leak, and erosion of the Dacron cuff.1-6 We report retention of a catheter fragment followed by recurrent bacteremia.

Report of a Case.—  A 56-year-old woman with a history of recurrent urinary tract infections was treated with a six-week course of ampicillin through a Hickman catheter for an Escherichia coli vertebral osteomyelitis. After an additional sevenday regimen of cefamandole for a urinary tract infection caused by Klebsiella pneumoniae, the catheter was removed.One month later, the patient experienced K pneumoniae sepsis (urine culture showed growth of only Candida tropicalis) for which she was treated with two weeks of cefotaxime via a second Hickman catheter. She was then transferred to a rehabilitation facility. Five weeks later, the patient again experienced K pneumoniae sepsis, which responded to cefotaxime.


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