Bacterial endocarditis in a child with haemophilia B: risks of central venous catheters

The use of central venous catheters may be complicated by thrombosis and in fection. We report a case of a needle-phobic 5-year-old boy with factor IX deficiency, in whom a portacath was inserted owing to poor compliance with prophylactic treatment. Within a week, he developed a Staphylococcus aureus line infection that was treated with a 2-week course of intravenous antibi otics. One month later he presented with nonspecific symptoms and blood cul tures again grew S. aureus. An echocardiogram revealed a large vegetation a dherent to the tricuspid valve, confirming the diagnosis of bacterial endoc arditis. His clinical course was further complicated by the development of pulmonary emboli. Medical treatment with intravenous antibiotics led to a s uccessful resolution of the endocarditis and pulmonary emboli with a favour able long-term outcome.