Multifocal Cerebral Microabscesses Secondary to Staphylococcus aureus Catheter-Related Bloodstream Infection in a Hemodialysis Patient

Staphylococcus aureus is a common cause of catheter-related bloodstream infections (CRBSIs) in patients undergoing hemodialysis, although cerebral microabscesses resulting from septic emboli are exceedingly rare. We describe a 37-year-old woman on chronic hemodialysis through a tunneled central venous catheter who presented with headache, limb weakness, and confusion without fever. Blood cultures confirmed methicillin-sensitive Staphylococcus aureus, and brain MRI demonstrated multifocal diffusion-restricted lesions consistent with microabscesses. Following prompt catheter removal and a six-week course of intravenous antibiotics, the patient achieved full neurological recovery and was transitioned to permanent vascular access. This case highlights the importance of early recognition of unusual neurological manifestations of Staphylococcus aureus CRBSI and the critical role of timely imaging and definitive source control in improving outcomes.