Infection of AV fistula

Background
  • Dialysis catheter–related bacteremia is common and potentially life-threatening

Clinical Features
  • Often presents with signs of systemic sepsis (fever, hypotension, leukocytosis)
    • Classic signs of pain, erythema, swelling, discharge from infected access are often missing

Differential Diagnosis

AV Fistula Complications

Workup
  • Draw peripheral and catheter blood cultures simultaneously
    • 4x higher colony count in catheter blood culture suggests catheter is source of bacteremia

Management
  • Give vancomycin 1gm IV +/- gentamicin 100mg IV (if gram neg suspected)
  • Do not remove dialysis patient's access
    • Catheter is only removed if fever persists for 2-3d after antibiotics are started

Disposition
  • Admit

See Also

References
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