A case of recurrent osteomyelitis due to retained micro-catheter after cerebral angiography

Abstract

Infections associated with healthcare manipulations, particularly bloodstream infections stemming from catheters and medical devices, significantly heighten the probability of vertebral osteomyelitis. The diagnosis of infective endocarditis (IE) frequently overlaps with vertebral osteomyelitis (VO). In cases where individuals are suspected of having hematogenous vertebral osteomyelitis and have an intravascular catheter or device, it is recommended to undertake blood culture collection. We present a case of a 39-year-old male with a history of interventional AVM embolization and cerebral angiography, experiencing recurrent vertebral osteomyelitis. No definitive source of infection had been found, and transthoracic echocardiography (TTE) yielded negative results for IE. In Trans Esophageal Echocardiography (TEE), a retained micro-catheter extending from the aortic arch to the inguinal artery was discovered. Although we cannot definitively attribute the source of the osteomyelitis to the retained micro-catheter, no episodes of infection have been reported ever since. This case underscores the need to enhance our approaches and guidelines related to operating protocols in the surgical setting. Improving these guidelines can prevent similar occurrences in the future, emphasizing the importance of continuous improvement in healthcare practices.

Keywords: Endocarditis; Microcatheter; Osteomyelitis.

Fig. 1

Wire-shaped mass (arrow) in the thoracic aorta in Trans-esophageal echocardiography.

Fig. 2

Thoracic section of wire-shaped enhancement in sagittal view of the thoracoabdominal CT scan.

Fig. 3

Abdominal section of wire-shaped enhancement in sagittal view of the thoracoabdominal CT scan.

Fig. 4

Segments of the removed microcatheter.