Clin Pediatr Hematol Oncol.  2018 Apr;25(1):61-65. 10.15264/cpho.2018.25.1.61.

Septic Arthritis and Infective Endocarditis in an Adolescent Hemophilia B Patient with an Inhibitor and a Central Venous Access Device

• Kim J
• Park YS

• KMID: 2435426
• DOI: http://doi.org/10.15264/cpho.2018.25.1.61

Abstract

Central venous access devices (CVAD) provide hemophilic patients, particularly children, with prolonged reliable venous access to promote routine factor replacement therapy. However, one of the significant complications of CVAD use is infection. We report the case of a severe hemophilia B patient with an inhibitor who developed septic arthritis and infective endocarditis associated with methicillin-resistant Staphylococcus aureus infection originating from a CVAD. Our patient had an underlying condition of congenital heart disease, one of the risk factors for infective endocarditis. Unfortunately, the antibiotic therapy did not have a significant effect. An echocardiogram revealed vegetation on the right ventricular moderate band and surgery was determined to be the best course of action. Septic arthritis and endocarditis rarely occur in hemophilia patients, however, they must be taken into account in hemophiliacs with continuing bacteremia.

Keyword

Central venous access devices; Hemophilia B; Ventricular septal defect; Infective endocarditis; Septic arthritis

MeSH Terms

Adolescent*
Arthritis, Infectious*
Bacteremia
Child
Endocarditis*
Heart Defects, Congenital
Heart Septal Defects, Ventricular
Hemophilia A*
Hemophilia B*
Humans
Methicillin-Resistant Staphylococcus aureus
Risk Factors