A 72-year-old man on haemodialysis via a tunnelled catheter develops fever and rigors 30 minutes into dialysis. Blood pressure is 92/54 mmHg and

Question

A 72-year-old man on haemodialysis via a tunnelled catheter develops fever and rigors 30 minutes into dialysis. Blood pressure is 92/54 mmHg and there is erythema over the tunnel. Blood cultures are drawn from catheter and peripheral sites. What is the most appropriate management?

Accepted Answer

Start intravenous antibiotics and arrange catheter removal if tunnel infection is confirmed

Answer

Treat with high-dose corticosteroids as the preferred next management strategy

Answer

Lock the catheter with heparin alone as the preferred next management strategy

Answer

Continue dialysis without cultures as the preferred next management strategy

Answer

Give oral antibiotics and use the catheter as usual as the preferred next step

Tunnelled haemodialysis catheter infection — ESENeph MCQ

A 72-year-old man on haemodialysis via a tunnelled catheter develops fever and rigors 30 minutes into dialysis. Blood pressure is 92/54 mmHg and there is erythema over the tunnel. Blood cultures are drawn from catheter and peripheral sites. What is the most appropriate management?