Infective Endocarditis as a Complication of a Permanent Indwelling Right Atrial Catheter in a Patient with Severe Aplastic Anaemia

Abstract

Endocarditis is a recognised complication of both temporary and permanent indwelling right atrial catheters. Endocardial damage by the catheter may result in non-bacterial thrombotic endocarditis. Sterile vegetations composed of platelets and fibrin may become infected, either by direct spread of bacteria along the catheter, or following an episode of bacteraemia. Bacteria in infected vegetations may be protected from phagocytosis by a ‘roof’ of fibrin.

Echocardiography is a valuable non-invasive method of diagnosis and may be used to monitor the resolution of vegetations and valve function. The right atrial catheter produces reflections which must be distinguished from cardiac abnormalities.

We report a case of infective endocarditis in a patient with severe aplastic anaemia and a permanent indwelling right atrial catheter which was managed conservatively.