Diferencia entre revisiones de «Infection of AV fistula»
(Created page with "==Background== ==Clinical Features== ==Differential Diagnosis== {{AV shunt complications DDX}} ==Workup== ==Management== ==Disposition== ==See Also== *Dialysis complic...") |
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==Background== | ==Background== | ||
*Dialysis catheter–related bacteremia is common and potentially life-threatening | |||
==Clinical Features== | ==Clinical Features== | ||
*Pts often p/w signs of systemic [[sepsis]] ([[fever]], [[hypotension]], leukocytosis) | |||
**Classic signs of pain, erythema, swelling, d/c from infected access are often missing | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Workup== | ==Workup== | ||
*Draw peripheral and catheter [[blood cultures]] simultaneously | |||
**4x higher colony count in catheter blood cx suggests catheter is source of bacteremia | |||
==Management== | ==Management== | ||
*Give [[vancomycin]] 1gm IV +/- genamicin 100mg IV (if gram neg suspected) | |||
*Do not remove dialysis patient's access | |||
**Catheter is only removed if fever persists for 2-3d after abx are started | |||
==Disposition== | ==Disposition== | ||
*Admit | |||
==See Also== | ==See Also== | ||
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==Sources== | ==Sources== | ||
<references/> | <references/> | ||
Revisión del 06:17 12 dic 2014
Background
- Dialysis catheter–related bacteremia is common and potentially life-threatening
Clinical Features
- Pts often p/w signs of systemic sepsis (fever, hypotension, leukocytosis)
- Classic signs of pain, erythema, swelling, d/c 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 cx suggests catheter is source of bacteremia
Management
- Give vancomycin 1gm IV +/- genamicin 100mg IV (if gram neg suspected)
- Do not remove dialysis patient's access
- Catheter is only removed if fever persists for 2-3d after abx are started
Disposition
- Admit