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I have been rounding a lot recently with Infectious Disease doc's. They have shown me beyond a shadow of a doubt, more then once, that you can have an infected line and all negative cultures (blood and tip). It is the power of deduction. A patient comes in sick as can be. Fever, chills, increased abnormal wht count, and has a vascular access device. They do blood cultures- all negative. They remove the device and culture the tip- comes back negative, but the patient show immediate signs of improvement after the device is removed. I asked why, and the attending told me that the line can be infected and not show any positive cultures. Something about biofilm and colonization. I'm learning. I'll get back to you when I can spout off long important terms and words.......
Heather Nichols RN BSN CRNI
Infusion Services University of Louisville Trauma Institute 530 S. Jackson St. Lou. Ky. 40202 (502)562-3530 >>> "Nancy Moureau" <[EMAIL PROTECTED]> 8/10/2006 3:08 PM >>> Sorry Rakay, Visible Bacteria in a CBC? I assume the white count was up. If all blood cultures are negative both peripheral and line draws then you may be talking about a contaminant. TPN is notorious for growing bacteria and certainly is a risk factor for infection. The patient may have a virus, esp with the glandular swelling.
Nancy Moureau, BSN, CRNI PICC Excellence, Inc [EMAIL PROTECTED] 1-888-714-1951 ---------- Original Message ---------------------------------- From: "Rakay Dance" <[EMAIL PROTECTED]> Date: Thu, 10 Aug 2006 12:41:33 -0600 >Hi, I am looking for some expert opinions. We had a PICC line in place >8 weeks. Pt is receiving TPN for extreme hyperemesis gravadarium. On >weekly labs Monday the lab noted visiable bacteria in the CBC. On >Tuesday PICC was pulled and repeat CBC and Blood cultures PIV were >drawn.&nb sp; No bacteria noted on this sample. Blood Cultures remain >negative after 48 hours. Is this likely a line infection or something >else. The tip was not cultured. Pt is now hospitalized and continues >to spike fevers and is on IVAB. Infection remains unknown. Pt's WBC >was 2.7 when admitted to hospital. Pt has very large swollen glands in >neck, headache and stiff neck. No spinal has been done. I would love >your opinion's-line infected or no?? RaKay > > >
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