Superior vena cava and right atrium wall infective endocarditis in patients receiving hemodialysis.

Infective endocarditis is significantly more common and causes greater morbidity and mortality in patients receiving hemodialysis than in the general population. Episodes of bacteremia during hemodialysis are primarily the result of frequent vascular access through an arteriovenous fistula, a vascular graft, or an indwelling vascular catheter. This leads to dialysis access infection and secondary bacteremia. We describe 4 cases of patients receiving hemodialysis, with an indwelling intravascular dialysis catheter, who developed right-sided endocarditis with vegetations located exclusively on the superior vena cava and right atrium wall. All patients had persistent bacteremia with Staphylococcus, secondary to an indwelling intravascular hemodialysis catheter, which led to seeding of the right-sided cardiac wall, causing infective endocarditis. The rates of acceptance for hemodialysis are increasing, along with improved survival in this group of patients. This will probably lead to an increase in the incidence of infective endocarditis, with atypical presentations such as superior vena cava and right-sided cardiac wall endocarditis. Published by Mosby, Inc.