Abstract

ONCE considered nonpathogenic commensals, coagulase-negative staphylococci have been cited with increasing frequency as pathogens. Currently, more than 20 species of coagulase-negative staphylococci have been delineated, but the majority of infections in man are caused by Staphylococcus epidermidis; this organism avidly infects in the presence of prosthetic devices and other foreign bodies (eg, intravenous catheters, central nervous system shunts, peritoneal dialysis catheters, and thoracotomy tubes). It is also commonly isolated from the blood of immunocompromised hosts, such as premature infants and patients with cancer.The symptoms and signs resulting from infection with coagulase-negative staphylococci are usually nonspecific, and often are limited to low-grade fever, but on rare occasions death has been either associated with or attributed to such infections. We report here a case in which a child with coagulase-negative staphylococcal bacteremia and pneumonia had sudden respiratory arrest after an infusion through an indwelling central venous catheter. We contend that the respiratory arrest was caused when large numbers of bacteria were dislodged from the catheter lumen and entered the bloodstream of this immunocompromised child. We hope that this report will alert clinicians to an uncommon (or infrequently recognized) but potentially life-threatening complication, caused in this case by an organism once thought to be inconsequential.