Infectious endocarditis in a patient with a transplanted kidney on a conventional hemodialysis

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Abstract

Infectious endocarditis remains challenging to diagnose, especially for patients with no apparent clinical symptoms. The presented clinical case describes a rapid progression of sepsis and challenges in treating a patient with risk factors, including undergoing immunosuppressive therapy due to a transplanted kidney, renal failure and the need for conventional dialysis. The case report highlights the significance of frequent monitoring of patients with the described risk factors, and emphasises the critical role of adopting more aggressive treatment strategies during the initial phases of the disease.

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About the authors

Anna A. Kozlova

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Author for correspondence.
Email: annakoz15@mail.ru
ORCID iD: 0009-0002-4321-1927

Assistant at the Department of Hospital Therapy named after P.E. Lukomsky of the Faculty of General Medicine

Russian Federation, Moscow

Yulia S. Agafonova

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: yuliaagaf2000@mail.ru
ORCID iD: 0009-0007-4877-9569

6th year student of the Faculty of General Medicine

Russian Federation, Moscow

Roman G. Timofeev

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: Timofrg@yandex.ru
ORCID iD: 0009-0000-2468-2200

6th year student of the Faculty of General Medicine

Russian Federation, Moscow

Vasily V. Mayorov

O.M. Filatov Municipal Clinical Hospital No. 15 of the Department of Healthcare of Moscow

Email: Vasso88-88@bk.ru

Head of the Department of Nephrology

Russian Federation, Moscow

Elena P. Merkusheva

O.M. Filatov Municipal Clinical Hospital No. 15 of the Department of Healthcare of Moscow

Email: lucky666_92@mail.ru

Nephrologist at the Department of Nephrology

Russian Federation, Moscow

Valentin A. Kokorin

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: valentinkokorin@yahoo.com
ORCID iD: 0000-0001-8614-6542

MD, Associate Professor, Professor the Department of Hospital Therapy named after P.E. Lukomsky of the Faculty of General Medicine

Russian Federation, Moscow

References

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  2. Демин А.А., Кобалава Ж.Д., Скопин И.И. с соавт. Инфекционный эндокардит и инфекция внутрисердечных устройств у взрослых. Клинические рекомендации 2021. Российский кардиологический журнал. 2022; 27(10): 113–192. [Demin A.A., Kobalava Zh.D., Skopin I.I. et al. Infectious endocarditis and infection of intracardiac devices in adults. Clinical guidelines 2021. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2022; 27(10): 113–192 (In Russ.)]. https://dx.doi.org/10.15829/1560-4071-2022-5233. EDN: DCXUXV.
  3. Тюрин В.П., Шевченко Ю.Л. Инфекционные эндокардиты: руководство. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа. 2013; 368 с. [Tyurin V.P., Shevchenko Yu.L. Infective endocarditis: A guide. 2nd ed., revised and additional. Moscow: GEOTAR-Media. 2013; 368 pp. (In Russ.)]. ISBN: 978-5-9704-2554-1.
  4. Chaudry M.S., Carlson N., Gislason G.H. et al. Risk of infective endocarditis in patients with end stage renal disease. Clin J Am Soc Nephrol. 2017; 12(11): 1814–22. https://dx.doi.org/10.2215/CJN.02320317.
  5. Nucifora G., Badano L.P., Viale P. et al. Infective endocarditis in chronic haemodialysis patients: An increasing clinical challenge. Eur Heart J. 2007; 28(19): 2307–12. https://dx.doi.org/10.1093/eurheartj/ehm278.
  6. Hoen B., Paul-Dauphin A., Hestin D., Kessler M. EPIBACDIAL: A multicenter prospective study of risk factors for bacteremia in chronic hemodialysis patients. JASN. 1998; 9(5): 869–76. https://dx.doi.org/10.1681/ASN.V95869.
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  8. Pericas J.M., Llopis J., Jimenez-Exposito M.J. et al. Infective endocarditis in patients on chronic hemodialysis. J Am Coll Cardiol. 2021; 77(13): 1629–40. https://dx.doi.org/10.1016/j.jacc.2021.02.014.
  9. Raza S., Hussain S.T., Rajeswaran J. et al. Value of surgery for infective endocarditis in dialysis patients. J Thorac Cardiovasc Surg. 2017; 154(1): 61–70.e6. https://dx.doi.org/10.1016/j.jtcvs.2017.02.063.

Supplementary files

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2. Fig. 1. Multispiral computed tomography of the chest organs of patient M.

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3. Fig. 2. Magnetic resonance imaging of the thoracic spine of patient M.: spondylodiscitis at the level of the Th8-Th9 segment

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