Running a fever - is my PermaCath infected?

[RightSide]

So believe it or not, this is still going on 

I finished my course of antibiotics a week ago today.  Then Monday during Dialysis I had horrible chills/shivers again.  Fever 101 thru the night, then normal the next morning.  No fever during dialysis Wed, but they did more blood cultures. Then Fri, got hooked up to the machine, and within the first half hour got the chills/shivers, and my temp went from 98 to 103 during my treatment!  Cultures came back positive again, but Neph says he doesn't understand the cultures because they don't look like what he usually sees, whatever that means.  Got a dose of IV antibiotics again before I went home.  Still can't believe they sent me home with that fever, but Neph says it must not be my permacath because it looks normal (no swelling, redness, pain, or drainage). 


I don't know what to do!!  I feel great when I'm not at dialysis, then I get horribly feverish when they hook me up and I'm sick all night.  Sitting thru treatments is agony for me, I've never been so cold in my life and there is no amount of clothing or blankets that can warm me up.

I really need some help with this, so please let me know if anyone has had a similar experience.

Yeah, that's what I was afraid of.

Your neph is incorrect.

Google for the term "biofilm."

Your catheter could have attached a film or coating of bacteria, which keeps "seeding" your bloodstream with infection, just as an abscessed tooth can do.  By now, the infection may have spread to one of your organs like the pancreas too.

The positive blood cultures suggest this is happening.  With a tiny pocket of infection stuck deep inside the catheter, antibiotics may not reach it in sufficient strength to eliminate it.  The answer is the same as for an abscessed tooth:  Not antibiotics, but removal. 

I've discussed this possibility with my own neph, and we agree that this is the best course of action.

I'm sorry.  I know you're not looking forward to having the catheter replaced.  But if there's an infectious biofilm coating it, then all the antibiotics in the world won't get rid of it.  Just like antibiotics won't cure an abscessed tooth.  It has to be removed.

Please keep us posted as to your progress.

[galvo]

I really hope you find a solution soon.

[boswife]

I was hoping it was better, so again i say, get it out and start again..  I know it's no fun and would scare me if hubby were doing that again, but infection scarres me more.  Get it done and start feeling better.  We worry for you.

[billybags]

I'm with nursewratchet, get it pulled I cannot believe they have left it for as long as this. Ok you will have to go on hemo for at least 8 weeks, that's what we do in the uk, its to make sure all the infection has cleared up, it is a pain in the backside but it has to be done. My husband had his pulled after only 1 week of infection, had emergency lines put in for hemo and now 3 months later he has a new cath and back on to PD. Stand your ground with the neph.

[fc2821]

  I had the same problem with my first cath when I started.  It is not plesant.

 

I cant believe they havent pulled it yet.  Its not a big deal, but it could save your life.  I'm not kidding, this can go directly to your heart.  GET IT OUT!!!!!  Get a new one, and a fistula. 

    This is correct.  You need to get this done as soon as possble. It IS infected    I hope your situtation improves. 

[RightSide]

At the risk of sounding a bit blunt, here's what may be at stake if the catheter is infected:

http://www.nlm.nih.gov/medlineplus/ency/article/000681.htm

If your neph does not take action soon, I strongly suggest getting a second opinion from another physician.

[kitkatz]

So believe it or not, this is still going on 

I finished my course of antibiotics a week ago today.  Then Monday during Dialysis I had horrible chills/shivers again.  Fever 101 thru the night, then normal the next morning.  No fever during dialysis Wed, but they did more blood cultures. Then Fri, got hooked up to the machine, and within the first half hour got the chills/shivers, and my temp went from 98 to 103 during my treatment!  Cultures came back positive again, but Neph says he doesn't understand the cultures because they don't look like what he usually sees, whatever that means.  Got a dose of IV antibiotics again before I went home.  Still can't believe they sent me home with that fever, but Neph says it must not be my permacath because it looks normal (no swelling, redness, pain, or drainage). 

I don't know what to do!!  I feel great when I'm not at dialysis, then I get horribly feverish when they hook me up and I'm sick all night.  Sitting thru treatments is agony for me, I've never been so cold in my life and there is no amount of clothing or blankets that can warm me up.

I really need some help with this, so please let me know if anyone has had a similar experience.

Have them put you on a non reuse dialyzer and change the one you are using.  I had this happen to me a few years ago and it was the fibers in the diayzer they were using.

[jennyc]

Oh Lori, Good luck your in our 

[galvo]

Lori, what's happening?

[Maker]

   Cultures came back negative today!!  I haven't run any sort of fever since last Friday night.  Dialysis session Monday went fine, so far today its going fine.

The question is...will the infection come back?  Praying I'm good till I can use my fistula.

Thanks to all of you for your concern and advice.  I was feeling pretty scared, but my neph continued to feel pulling it was premature.  I had a really rough recovery from the initial surgery so I'm hoping not to go thru that again.

[boswife]

whew!!  i tell ya, sometimes (sometimes! ) we have to trust they know what they're doing.  Sounds like they did, and that all will be well  Good for you for keeping on them though.. Just seems like we have to do our own pushing at times,  and im glad your getting closer and closer to geting to use your fistula.  Soooooo much better!!! 

[galvo]

Excellent!

[fc2821]

  Good news. Glad I was wrong and you are doing ok. Hope you will able to use the fistula soon. 
                                                                           Rob