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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2003  |  Volume : 14  |  Issue : 4  |  Page : 511-515
Vascular Steal Syndrome and Shewanella alga Infection Requiring Amputation in a Hemodialysis Patient

1 Department of Internal Medicine, University of Texas Medical Branch at Galveston, Texas, USA
2 Division of Nephrology, University of Texas Medical Branch at Galveston, Texas, USA

Correspondence Address:
Mahendra Agraharkar
Department of Medicine, Nephrology Division, University of Texas Medical Branch, 4200 John Sealy Annex, 301 University Boulevard, Galveston, Texas 77555-0562
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PMID: 17657124

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Shewanella alga is a rare gram-negative marine bacterium. Its role as a pathogenic organism is gradually evolving with sporadic cases being reported in humans. We report a case of vascular steal syndrome secondary to a polytetrafluoroethylene (PTFE) graft in the upper extremity of an end-stage renal disease (ESRD) patient on maintenance hemodialysis, which was complicated by infection with S. alga. This resulted in extensive myonecrosis requiring amputation of the limb. To our knowledge this is the fourth case of primary S. alga infection, and the first case in a hemodialysis patient reported in the medical literature from the United States. We also discuss the biochemical tests for identification and differentiation of S. alga from a closely related strain S. putrefaciens.

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