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A man in his mid-50s presented to the hospital with malaise, fevers, hypotension, and altered mental status. Three months prior, he had an episode of native aortic valve endocarditis, necessitating aortic valve replacement with a pericardial bioprosthesis. He developed postoperative acute renal failure, which progressed to chronic renal failure requiring dialysis via tunneled catheter. On this admission, he was found to have methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Transesophageal echocardiography demonstrated a vegetation on his prosthetic aortic valve. He was diagnosed as having MRSA prosthetic valve endocarditis and admitted to the cardiovascular surgical intensive care unit prior to surgical intervention.
DiBrito SR, Stephens RS. Unpredictable Location of Central Catheter. JAMA Surg. 2014;149(8):871-872. doi:10.1001/jamasurg.2013.3779