Time | Event |
---|---|
Day 0 | 28yo woman with end-stage renal disease in the setting of IgA nephropathy undergoes right IJ tunneled HD catheter placed for initiation of hemodialysis |
Day 47 | Presents to outside hospital with SVC syndrome and started on intravenous heparin |
Day 51 | Transferred to our hospital with SVC syndrome and bacteremia (on IV heparin and IV vancomycin) for consideration of advanced interventions involving the HD catheter |
Day 55 | Due to the persistence of thrombus-associated SVC syndrome, HD catheter is removed and replaced; IV vancomycin and IV heparin are continued, and coumadin is initiated |
Day 60 | Develops right-sided chest pain with fever; CT angiography demonstrates R-sided pulmonary embolism |
Day 63 | Develops pleuritic chest pain with blood tinged sputum; CT chest demonstrates pulmonary infarction |
Day 69 | Resolution of symptoms; discharged with six-month course of coumadin, 28-day course of vancomycin, and outpatient hemodialysis |
Day 268 (approximately 9 months after discharge) | Underwent renal transplant |