58 year old male patient with persistent MRSA bacteremia. Evaluate left upper arm near graft site for abscess. Targeted ultrasound performed over the patient's left upper arm arteriovenous graft demonstrates an elongated 2.7 x 0.5 x 1.2 cm area of subcutaneous heterogeneity superficial to the AVG with a small amount of insinuating fluid. A region of hypoechogenicity also extends from this to the posterior surface of the AVG along one side. There is no significant increased vascularity of this region on color Doppler imaging. Flow is identified within the graft.
Heterogeneity of the subcutaneous tissues with a small amount of fluid anterior to the AVG favored to represent a small complex hematoma given patient's history; no surrounding hypervascularity visualized but superimposed infection not entirely excluded, correlate with patient's laboratory values/physical exam. 