Diferencia entre revisiones de «Infection of AV fistula»
| (No se muestran 6 ediciones intermedias de 4 usuarios) | |||
| Línea 3: | Línea 3: | ||
==Clinical Features== | ==Clinical Features== | ||
* | *Often presents with signs of systemic [[sepsis]] ([[fever]], [[hypotension]], leukocytosis) | ||
**Classic signs of pain, erythema, swelling, | **Classic signs of pain, erythema, swelling, discharge from infected access are often missing | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Línea 11: | Línea 11: | ||
==Workup== | ==Workup== | ||
*Draw peripheral and catheter [[blood cultures]] simultaneously | *Draw peripheral and catheter [[blood cultures]] simultaneously | ||
**4x higher colony count in catheter blood | **4x higher colony count in catheter blood culture suggests catheter is source of bacteremia | ||
==Management== | ==Management== | ||
| Línea 26: | Línea 26: | ||
==External Links== | ==External Links== | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Renal]] | |||
[[Category:Vascular]] | |||
[[Category:ID]] | |||
Revisión actual - 17:11 16 oct 2019
Background
- Dialysis catheter–related bacteremia is common and potentially life-threatening
Clinical Features
- Often presents with signs of systemic sepsis (fever, hypotension, leukocytosis)
- Classic signs of pain, erythema, swelling, discharge from infected access are often missing
Differential Diagnosis
AV Fistula Complications
- Clotting of AV fistula
- Infection of AV fistula
- Hemorrhage of AV fistula
- Vascular insufficiency from AV fistula
- AV fistula aneurysm/pseudoaneurysm
- High-output heart failure from AV fistula
Workup
- Draw peripheral and catheter blood cultures simultaneously
- 4x higher colony count in catheter blood culture suggests catheter is source of bacteremia
Management
- Give vancomycin 1gm IV +/- gentamicin 100mg IV (if gram neg suspected)
- Do not remove dialysis patient's access
- Catheter is only removed if fever persists for 2-3d after antibiotics are started
Disposition
- Admit