A 46-year-old male, hypertensive, hyperuricemic and with CRE possibly secondary to chronic glomerulonephritis (GN), on HD since 1995.
He received two cadaveric kidney transplants, with early recurrence of possibly malignant nephropathies, re-initiating HD in 2004.
The patient had multiple vascular accesses, the last one had a prosthetic AVF (polytetrafluoroethylene) - self-axillary - presenting ulceration in the left prosthesis and exposed skin to anastomosis, with secretion,
Transient CVC is implanted and the ulcer is cultured, growing AX.
No elevation of acute phase reactants or systemic infection data were observed.
He received intravenous antibiotics according to the antibiogram, after which the culture was repeated, persisting the development of AX.
He received new antibiotic tandes, without being able to eradicate the germ (three positive cultures to AX), so it was decided to surgically remove the prosthesis and perform a new vascular access (femoral AVF).
The subsequent culture of the surgical wound is negative for AX.
