KEY ASSESSMENTS 5
- Purulent discharge from exit-site, spontaneous or expressed from tunnel, cuff or sinus
- Persistent erythema may be precursor to purulent drainage5
- Erythema, induration, or tenderness at exit-site or over the tunnel5
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Possible indications for ultrasound (US) of catheter tunnel:5
- initial evaluation of suspected tunnel infection with or without clinical features of tunnel involvement (especially if caused by S. Aureus)
- follow-up of exit-site and tunnel infection after antibiotic treatment
- relapsing peritonitis (may be due to an occult tunnel infection)
- Positive culture with normal appearing site may indicate colonization vs infection
- Erythema or skin reaction may be noted following catheter implantation or trauma3
- Staphylococcus aureus carrier status/use of prophylaxis5
- Compliance with prophylaxis
- Precipitating or contributing conditions (a break in technique, gross contamination, etc.)
- Suboptimal exit-site care
- Exit-site infection with S. Aureus and pseudomonas are often associate with concomitant tunnel infection5
