Renal disease patients undergoing chronic hemodialysis are vulnerable to infectious diseases. Both the immunocompromised state of chronic renal disease patients and the presence of endovascular structures and devices such as hemodialysis arteriovenous fistulas and central venous catheters create a favorable environment for infectious complications, mainly bacteremia.(11 Strateva T, Kostyanev T, Setchanova L. Ralstonia pickettii sepsis in a hemodialysis patient from Bulgaria. Braz J Infect Dis. 2012;16(4):400-1.) This study's main point of interest is that it stresses the high level of clinical suspicion that physicians should have when treating patients with intravascular devices and bacteremia.(22 Tejera D, Limongi G, Bertullo M, Cancela M. Ralstonia pickettii bacteremia in hemodialysis patients: a report of two cases. Rev Bras Ter Intensiva. 2016;28(2):195-8.) In this context, despite the few cardiovascular symptoms manifested by gram-negative endocarditis, particularly in cases involving endocarditis caused by infrequent and low-virulence microorganisms, a transesophageal echocardiogram-based search for valvular vegetation is suggested for all patients on hemodialysis with bacteremia.(22 Tejera D, Limongi G, Bertullo M, Cancela M. Ralstonia pickettii bacteremia in hemodialysis patients: a report of two cases. Rev Bras Ter Intensiva. 2016;28(2):195-8.) In our setting, there were no new cases; however, infectious agents were isolated in the two described patients, and health control and prevention measures were implemented.
Darwin Tejera
Asociación Española - Montevideo, Uruguay.
REFERENCIAS
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1Strateva T, Kostyanev T, Setchanova L. Ralstonia pickettii sepsis in a hemodialysis patient from Bulgaria. Braz J Infect Dis. 2012;16(4):400-1.
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2Tejera D, Limongi G, Bertullo M, Cancela M. Ralstonia pickettii bacteremia in hemodialysis patients: a report of two cases. Rev Bras Ter Intensiva. 2016;28(2):195-8.
Publication Dates
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Publication in this collection
Oct-Dec 2016
