Sudden Fever

[redz812]

Hi everyone,

Yesterday my hubby experienced sever chills and a fever of 101.3. He has been on home hemo w/pureflow for over 6 mos with very minor problems, mostly equipment.

Yesterday, everything was going smoothly but he starting getting chills and shaking about 1 hr into his 3 hr session. He bundled up, turned up the portable heater and went thru with his treatment. After coming off, he took his temp and it was 101.3. We went to the ER and they kept him over nite while administering iv antibiotics.

Everyone is stumped as to why this happened. He is meticulous about keeping everything sterile. What do you think? Anyone have this happen to them?

Thanks....

[Roadrunner]

Hubby probably has an infection.  These things happen even with care.  Does he have a catherer?  Bacteria can attach to the plastic.  See your doctor or he will have worse chills at his next dialysis.  Don't let an infection get a head start.

Good Luck and follow up.

Roadrunner

[redz812]

Roadrunner, thanks for your reply. No he has buttonholes. He is being treated in the hosp now with iv antibotics. We hope he is getting home today or tomorrow....Don't want to miss the Super Bowl!!

[Hawkeye]

It could be the machine too.  Just because he tries to keep things sterile doesn't mean anything. When was the last time the cartridge/filter was changed? Do you do regular testing for bacteria and LAL in the dialysate?  If the LAL is above a certain level (.06 by Fresenius standards, above .25 by AAMI standards) that could have caused the issue.

[Russ]

It could be the machine too.  Just because he tries to keep things sterile doesn't mean anything. When was the last time the cartridge/filter was changed? Do you do regular testing for bacteria and LAL in the dialysate?  If the LAL is above a certain level (.06 by Fresenius standards, above .25 by AAMI standards) that could have caused the issue.

For what it's worth, we tested the dialysate from the Pureflow unit last week and it came back positive.  We then changed out the filtration pack in the Pureflow unit and retested the dialysate and it tested negative.

[jbeany]

Hawkeye, NxStage uses a new filter for every treatment.

Red, how's he doing now?  Did the antibiotics help?

[Roadrunner]

When was the last time the cartridge/filter was changed? Do you do regular testing for bacteria and LAL in the dialysate?  If the LAL is above a certain level (.06 by Fresenius standards, above .25 by AAMI standards) that could have caused the issue.

We have had the NxStage since Thanksgiving.  The nurse tested the machine when it was set up and I test regularly for chlorimines but I have never tested for bacteria and LAL.  What is LAL?  How do you test it.  Is this something I need to do or does the nurse need to come and do the test?

[Hawkeye]

Hawkeye, NxStage uses a new filter for every treatment.

Red, how's he doing now?  Did the antibiotics help?

Ah, I didn't realize.  Not too familiar with the NxStage operations.

[Hawkeye]

We have had the NxStage since Thanksgiving.  The nurse tested the machine when it was set up and I test regularly for chlorimines but I have never tested for bacteria and LAL.  What is LAL?  How do you test it.  Is this something I need to do or does the nurse need to come and do the test?

Bacteria and LAL's are both things that would be tested by taking a sample of the dilaysis fluid that is used during the treatment.  These sample would then be sent to a lab or your local clinic for processing.  How it would be taken or where I couldn't say.  I know we have to test our entire water system and 1/3 of the machines on a monthly basis for both Bacteria and LAL's.  As for what LAL's are...well this is gonna sound kinda gross but LAL's are basically the dead bacteria that is killed during the disinfecting process.