Pyrexia of unknown origin in a haemodialysis patient

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 intraand post-dialysis fevers is presented as a teaching case.