question: CRBSI

[Betsy Harmon]

New question for the group.   Had a physician today ask if I had ever heard of a patient having an infected CVC or PICC but was totally asymptomatic?  No erythema, tenderness, drainage, etc at the insertion site of up the extremity for a PICC.  No other symptoms except for a high WBC?    CT of head chest and abd done today on patient Blood cultures pending Sputum cultures growing lots of funky stuff.  No CXR ordered since 10/13/05 UA sent for culture and sensitivity pending Pt has partial Bowel obstruction. Has g-tube, and severe abd tenderness PICC site soft, non-tender complete up inner aspect of arm to axilla when palpated.  No increase in arm circumference, no increase in forarm circumference.  No pain across anterior chest, both lumens flush like a dream.  No erythema, drainage or swelling at insertion site.  Physicians want to pull the PICC for suspected infection source.  Any help to the two questions posed in the first paragraph?  I have asked enough questions about the patient they are waiting until something really indicates the PICC as the source.  We do not do "time to positivity" cultures yet at our facility, the lab is looking into this for me.   Thanks in advance.   Betsy Harmon RN BSN CRNI Vascular Access Team Critical Care Unit Alaska Native Medical Center Anchorage, Alaska [EMAIL PROTECTED]