A Devastating Complication of Central Venous Catheter Insertion

Maryam Bahreini; Alireza Jalali; Atefeh Abdollahi; Babak Choobi Anzali

doi:10.6705/j.jacme.201906_9(2).0005

A Devastating Complication of Central Venous Catheter Insertion

J Acute Med. 2019 Jun 1;9(2):69-72. doi: 10.6705/j.jacme.201906_9(2).0005.

Authors

Maryam Bahreini¹, Alireza Jalali^#², Atefeh Abdollahi¹, Babak Choobi Anzali³

Affiliations

¹ Sina Hospital, Tehran University of Medical Sciences Department of Emergency Medicine.
² Zabol University of Medical Sciences Zabol Iran.
³ Urmia University of Medical Sciences Urmia Iran.

^# Contributed equally.

Abstract

Retained guidewire is a major complication of central line placement. We present a patient with infective endocarditis caused by a retained guidewire. A young man admitted to our emergency department complained of debilitating weakness, productive cough, and fever for seven days. Chest radiography showed some lesions in both lungs as well as a retained guidewire. Past history revealed a thermal burn injury one month before, during which an internal jugular central venous line was inserted. Echocardiography showed multiple large vegetations in right atrium and right ventricle. Thus, infective endocarditis and multiple embolic lung lesions were treated with empirical antibiotics. Guidewire was removed by vascular surgery service. Unfortunately, the patient died before undergoing open-heart surgical intervention. It is believed that central vein catheterization requires special attention to perform through the Seldinger technique skillfully and under supervision to avoid preventable complications.

Keywords: central venous catheterization; complication; infective endocarditis.

Publication types

Case Reports