Infection of AV fistula
Revisión del 06:08 12 dic 2014 de Rossdonaldson1 (discusión | contribs.) (Created page with "==Background== ==Clinical Features== ==Differential Diagnosis== {{AV shunt complications DDX}} ==Workup== ==Management== ==Disposition== ==See Also== *Dialysis complic...")
Background
Clinical Features
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
Management
Disposition
See Also
External Links
Sources
Infection of AV fistula
- 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
- Dialysis catheter–related bacteremia is common and potentially life-threatening
- Give vancomycin 1gm IV +/- genamicin 100mg IV (if gram neg suspected)
- Do not remove dialysis patient's access
- Draw peripheral and catheter blood cultures simultaneously
- 4x higher colony count in catheter blood cx suggests catheter is source of bacteremia
- Even so catheter is only removed if fever persists for 2-3d after abx are started
- 4x higher colony count in catheter blood cx suggests catheter is source of bacteremia