67-year-old woman from Bulgaria, hypertensive, diabetic, obese, dyslipidaemic and with chronic kidney disease (CKD) possibly secondary to diabetes and/or nephroangiosclerosis, on HD since January 2008. Low socioeconomic status, living with animals and poor personal hygiene.
Left humerocephalic arteriovenous fistula (AVF) was performed, with a torpid evolution, performing HD by transient CVC (multiple withdrawals and new cannulations due to catheter entry site infections [PEC]).
She was admitted with fever and chills after dialysis, compatible with bacteraemia, with positive blood cultures for Staphylococcus (St.) aureus. He associated infection in PEC, so the catheter was removed, which was cultured, growing AX, together with St. aureus and Enterococcus faecalis. With combined treatment for the three germs, the clinical and bacteriological infectious picture disappears.