Tunnel infection: Difference between revisions

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(Created page with "== Management == * Send cultures of any drainage and send blood cultures * Remove catheter, without exchange over a wire * Insert replacement catheter at distant site * Antib...")
 
 
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== Management ==
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==Background==
   
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*A type of [[central line infection]] characterized by signs of soft tissue infection extending along the tunneled portion of the catheter
* Send cultures of any drainage and send blood cultures
 
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* Remove catheter, without exchange over a wire
 
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===Case Definition===
* Insert replacement catheter at distant site
 
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* Antibiotics
 
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====IDSA====
** Cover Gram-positive and Gram-negative organisms, and adjust based on culture results
 
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** Without bacteremia, treat for 10 to 14 days
 
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*Tenderness, hyperemia, and/or induration that extends >2 cm from the exit site and along the subcutaneous tunnel
** With bacteremia, see [[Central line-associated bloodstream infection#Management|central line-associated bloodstream infection]] for management
 
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*May or may not be associated with bacteremia
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====CDC====
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*Tenderness, erythema, or site induration >2 cm from the catheter site along the subcutaneous tract of a tunneled catheter, in the absence of concomitant [[Central line-associated bloodstream infection|bloodstream infection]]
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==Management==
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*Send cultures of any drainage and send blood cultures
 
*Remove catheter, without exchange over a wire
 
*Insert replacement catheter at distant site
 
*Antibiotics
 
**Cover Gram-positive and Gram-negative organisms, and adjust based on culture results
 
**Without bacteremia, treat for 10 to 14 days
 
**With bacteremia, see [[Central line-associated bloodstream infection#Management|central line-associated bloodstream infection]] for management
   
 
[[Category:Infectious syndromes]]
 
[[Category:Infectious syndromes]]

Latest revision as of 14:44, 7 February 2021

Background

  • A type of central line infection characterized by signs of soft tissue infection extending along the tunneled portion of the catheter

Case Definition

IDSA

  • Tenderness, hyperemia, and/or induration that extends >2 cm from the exit site and along the subcutaneous tunnel
  • May or may not be associated with bacteremia

CDC

  • Tenderness, erythema, or site induration >2 cm from the catheter site along the subcutaneous tract of a tunneled catheter, in the absence of concomitant bloodstream infection

Management

  • Send cultures of any drainage and send blood cultures
  • Remove catheter, without exchange over a wire
  • Insert replacement catheter at distant site
  • Antibiotics