Tunnel infection: Difference between revisions

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== Management ==
== Background ==


* A type of [[central line infection]]
* Send cultures of any drainage and send blood cultures

* Remove catheter, without exchange over a wire
=== Case Definition ===
* Insert replacement catheter at distant site

* Antibiotics
==== IDSA ====
** Cover Gram-positive and Gram-negative organisms, and adjust based on culture results

** Without bacteremia, treat for 10 to 14 days
* 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
* 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 [[Central line-associated bloodstream infection|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
**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]]

Revision as of 18:42, 7 February 2021

Background

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