Patient complains of fevers, chills and pus coming from central line exit site. What is the diagnosis?
The correct answer is a. Central line exit-site and tunnel infectionPatients may complain of redness, swelling and tenderness over the central line tunnel. There may be a purulent or bloody discharge coming from the exit site. This must be differentiated from clear exudate, which may be normal. Gram positive organisms arising from the skin like Staphylococcus aureus are the most common culprits. Ultrasound of the tunnel is useful to evaluate for the presence of abscess, especially if exam is borderline. Treatment entails central line removal.
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