Sammanfattning
BACKGROUND: Permanent central venous catheters have gained widespread use. They provide easy vascular access, enabling various intravenous therapies. However, there are potentially serious complications associated with these catheters. We present a case report with an unusual finding that strikingly illustrates some of these concerns.
CASE PRESENTATION: A man in his mid-fifties was admitted to the hospital with symptoms of septicaemia and a swelling on the left side of the neck. He had been diagnosed with B-cell lymphoma, complicated by a tumour causing gastrointestinal obstruction. Following abdominal surgery, he had been hospitalised for several weeks due to postoperative complications and subsequent multiorgan failure. He had been discharged from hospital three days prior to the admission in question. The initial diagnostic survey revealed an unusual finding: a massive central venous thrombosis with air bubbles dispersed throughout the thrombus, strongly indicative of a septic thrombus.
INTERPRETATION: Thrombosis related to indwelling central venous catheters may be difficult to detect; the clinical symptoms may be absent or very subtle. However, a thrombus may represent an ideal substrate for bacterial growth. An infected thrombus should thus be considered when a patient with a central venous catheter presents with septicaemia of unknown origin.