The clinical data of a patient with CRBSI complicated with UGB were collected， the clinical manifestations， auxiliary examination， treatment plan and prognosis were analyzed， and the relevant literatures were reviewed.

The 57-year-old male patient was hospitalized for regular hemodialysis for 1 year， black stool for 2 weeks and fever for 3 d. After admission， the patient developed high fever with chills， blurred consciousness， decreased blood pressure， anuria， procalcitonin exceeding the upper limit， etc. The main diagnosis was chronic kidney disease stage 5， long-term dialysis CRBSI， UGB and septic shock. Anti-shock and experimental anti-infection treatment were given immediately after admission. At the same time， catheter blood， peripheral blood culture and drug sensitivity test were carried out. After the results were returned， the antibiotic regimen was adjusted， and removal of long-term dialysis catheter， control of UGB， kidney protection， arteriovenous fistula（AVF） hemodialysis， symptomatic and supportive treatment were given. After 18 d， the patient recovered and was discharged.

CRBSI complicated with UGB seriously endangers the life and health of patients. In order to improve the prognosis， it is recommended to establish AVF pathway as soon as possible in the patients with long-term internal jugular vein catheterization hemodialysis. If there are serious complications such as septic shock during the course of the disease， anti-infection treatment can be carried out at the same time， and the treatment plan should be adjusted in the treatment process. In addition， it is necessary to pay attention to the risk of UGB in the maintenance hemodialysis patients.