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Graft Infection and Bacteremia

Thomas D. Wooldridge, MD; John W. Cox, MD
Arch Intern Med. 1983;143(5):1070. doi:10.1001/archinte.1983.00350050240048.
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To the Editor.  —The report by Zeitlin et al in the November Archives (1982; 142:2191-2192) concerned a case of Listeria monocytogenes bacteremia in a patient receiving hemodialysis. Recently we have also noted a case of Listeria sepsis in a patient receiving dialysis, with a fatal outcome.

Report of a Case.  —A 56-year-old man had been receiving hemodialysis for eight years. His vascular access was through a left forearm arteriovenous graft, but he had had no access surgical procedures in the previous eight months.The patient felt well prior to dialysis on admission to the hospital, but suddenly became hypotensive during the dialysis procedure. Physical examination findings were negative except for a BP of 85/45 mm Hg sitting and supine. The patient's mental status was normal. Laboratory work revealed a blood glucose level of 36 mg/dL. This was immediately after hemodialysis, with dialysate containing a glucose concentration of 200 mg/dL. Sepsis


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