A high index of suspicion is warranted for catheter sepsis in | Surgery videos & books

A high index of suspicion is warranted for catheter sepsis in any patient who has had a central line for several days and suddenly spikes a high fever. The catheter site may have erythema, induration, tenderness, and purulent discharge extruding from the skin. Often, however, the skin appears normal. Athorough search for other possible sources of fever including pulmonary, intra-abdominal, urinary, and wound infections is always prudent. Catheter sepsis can be life threatening and early intervention is essential. Peripheral and central blood cultures should be obtained and the catheter must be removed promptly. It is contraindicated to replace the catheter over a guide wire because the skin tract is infected. It is not mandatory to treat with antibiotics unless the fever persists or signs of sepsis are present.