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September 1972

Staphylococcal Endarteritis in a Renal Arteriovenous Fistula Following Nephrectomy

Author Affiliations


From the departments of medicine (Drs. Wang, Hall, and Gobel) and surgery (Dr. Sako), Veterans Administration Hospital, and the University of Minnesota (Drs. Wang, Sako, Hall, and Gobel), Minneapolis.

Arch Intern Med. 1972;130(3):418-421. doi:10.1001/archinte.1972.03650030092021

Renal arteriovenous (AV) fistula is an unusual but well-known complication of nephrectomy.1,2 Rarely, bacterial endarteritis may complicate an acquired AV fistula, giving rise to a clinical picture similar to that of bacterial endocarditis.3-19 This report presents a case of successfully treated staphylococcal endarteritis in a renal AV fistula 19 years following nephrectomy.

Patient Summary  42-year-old white man was admitted to a local hospital on June 5, 1970, because of the sudden onset of chills and fever. Examination at the time of admission revealed a temperature of 104 F (40 C) and a soft systolic ejection murmur along the left sternal border. A blood culture was positive for coagulase-positive Staphylococcus aureus. The patient was treated with cephaloridine, sulfamethoxazole, and ampicillin sodium, but his fever continued. There was no history of rheumatic fever, scarlet fever, or heart disease. In 1951, the patient underwent nephrectomy on the left for hydronephrosis caused

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