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Conflict of Interests The authors declare that there is no conflict of interests regarding the publication of this paper.Infection is a common complication of central venous catheters (CVC) used for vascular access in hemodialysis patients. Gram-positive bacteremia is the typical clinical presentation of CVC related infectious complications. Pseudomonas aeruginosa is a less frequent pathogen associated with catheter infection, accounting for 4�C16% of isolates [1]. Nevertheless, this pathogen should always be considered as one potential causative agent of CVC related infections, especially in immunocompromised hosts. Metastatic infectious foci are important determinants Phosphorylase of the morbidity and mortality of CVC related infections. Endocarditis, septic embolism, and visceral abscesses are rare but serious complications whose mere suspicion demands careful clinical and radiological search. We report a case of a subphrenic abscess and CVC related bloodstream infection with Pseudomonas aeruginosa in a 59-year-old woman on haemodialysis. 2. Case Report A 59-year-old woman with a history of mild intellectual disability and chronic renal allograft dysfunction was admitted to our hospital with a febrile syndrome and a progressive ten-day history of nonproductive cough. She was receiving haemodialysis at a satellite dialysis unit, through a jugular permanent catheter, which had been placed 93 days before. She was not taking corticosteroids or any other immunosuppressive agents, and she had no GANT61 order history of any intra-abdominal disease or recent surgical procedure. The patient complained of intermittent chills and fever up to 39��C for the last few days, with no close temporal relationship with the dialysis session. The rest of anamnesis was anodyne. Physical examination showed a blood pressure see more of 100/50mmHg, respiratory rate of 19 breaths/min, and temperature of 38.4��C. Chest auscultation revealed regular heart sounds with a pansystolic murmur, which had already been described in her clinical history, and the breath sounds were absent in the lower third of the right lung. The abdominal exam did not reveal tenderness, hepatomegaly, or masses. Jugular catheter inspection showed inflammatory signs and mild purulent discharge around the exit site. Her initial WBC was 16 �� 109 cells/L (normal range: 4.5�C10.5 �� 109 cells/L), and she had an absolute neutrophil count of 13 �� 109 cells/L. C-reactive protein was 230mg/L (normal range: 1�C5mg/dL) and procalcitonin was 1.2ng/mL (