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April 18, 1986

The Removal of Central Venous Silicone Rubber Catheters

JAMA. 1986;255(15):2022. doi:10.1001/jama.1986.03370150063012

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.