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NDT Plus Advance Access published online on January 19, 2008
NDT Plus, doi:10.1093/ndtplus/sfm045
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Pyrexia of unknown origin in a haemodialysis patient

A. Davenport

UCL Center for Nephrology, Hampstead Campus, Royal Free & University College Medical School, Rowland Hill Street, London NW3 2PF, UK

Correspondence: A. Davenport, UCL Center for Nephrology, Hampstead Campus, Royal Free & University College Medical School, Rowland Hill Street, London NW3 2PF, UK. E-mail: Andrew.davenport@royalfree.nhs.uk

Key Words: ethylene oxide • haemodialysis • pyrexia • rigors

Received for publication December 3, 2007. Accepted for publication December 12, 2007.

The first 150 words of the full text of this article appear below.


   Introduction
 
The most common cause of pyrexial reactions in the haemodialysis patient remains bacterial infections. The incidence of infection is increased in the dialysis patient [1], particularly due to indwelling central venous catheters. Pyrexial reactions have been reported with microbacterial contamination of the dialysate [2], but these are now rare events, due to the regular testing of dialysate water.

Occasionally, patients may react to a component in the extracorporeal circuit. These reactions vary from local eczematous skin eruptions, to a variety of systemic reactions, ranging from headache to anaphylaxis [3].

A case of recurrent intra- and post-dialysis fevers is presented as a teaching case.


   Case
 
A 45-year-old man, who emigrated from the Caribbean to the UK when aged 8 years, developed end-stage kidney disease in July 2003. He had completed a 2-year course of anti-tuberculous chemotherapy for pulmonary TB in 1972.

He was started on peritoneal . . . [Full Text of this Article]


   Discussion
 

   Teaching points
 

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