Blood-stream infection and atrial thrombus due to a buried and forgotten permanent haemodialysis catheter

An 80-year-old man maintenance haemodialysis patient was admitted to the haemodialysis inpatient unit with complaints of chills and fever after haemodialysis sessions. The patient had been undergoing haemodialysis for 3.5 years thrice weekly. One year prior to current admission his right-sided permanent haemodialysis catheter was withdrawn and a new permanent catheter was inserted on the same side in another centre. Chest x-ray (figure 1A) showed that there were two catheter images in the right chest. The catheter which was thought that previously was taken out was still in place. The catheter was broken in the subcutaneous tunnel but the catheter tip was still in the right ventricular cavity. The second catheter image belonged to the current functional catheter. It lay parallel to the previous catheter until the right atrial caval vein junction. …