Cavitary pulmonary disease in a patient on dialysis.

A 24-year-old man on maintenance hemodialysis presented with bilateral cavitary consolidations and methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia following ulceration of the skin over his arteriovenous (AV) fistula cannulation site. A diagnosis of septic pulmonary embolism was made, which presumptively originated from a localized MSSA infection of his AV access. He had an excellent response to a 28-day course of cloxacillin, with the resolution of the pulmonary lesions.