Catheter salvage with antibiotic lock therapy for central venous port infection due to Pseudoxanthomonas sp. in a child with hemophilia B.
Hidemasa Akazawa, Shinnosuke Fukushima, Kenta Nakamoto et al.
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Case in brief
A 4-year-old boy with severe hemophilia B developed persistent bacteremia associated with an implanted central venous port. Bloodstream infection was attributed to Pseudoxanthomonas sp., identified by MALDI-TOF mass spectrometry and 16S rRNA gene sequencing. Port removal was considered high risk because of potential major bleeding. He received systemic antibiotics, adjusted during treatment, together with antibiotic lock therapy; the lock solution was changed after suspected drug fever. The infection resolved, the port was retained, and no recurrence was observed during four months after therapy.
What made this case unusual
The infection was caused by Pseudoxanthomonas sp., an environmental Gram-negative bacillus, and catheter removal posed particular hemorrhagic risk because the child had severe hemophilia B.
Diagnostic / clinical pearl
When port removal carries substantial bleeding risk, systemic antimicrobial therapy combined with antibiotic lock therapy may permit catheter salvage, as in this child with Pseudoxanthomonas sp. bacteremia.