Haemodialysis access graft infection is easily recognizable when local
symptoms (warmth, swelling, pain, or drainage) predominate, and endoc
arditis is a well established complication of infected grafts. We repo
rt a case of bacterial endocarditis complicating silent infection in c
lotted haemodialysis access graft. It Is suggested that? clotted non-f
unctioning grafts may be the harbingers of silent infection, and shoul
d be suspected as the source of infection in every haemodialysis patie
nt that presents with fever, even in the absence of clinical signs of
graft site infection.