Intravenous line infections

Centrally-placed i.v.-line infections are a frequent cause of fever in the critical care unit. i.v.-line infection is not usually accompanied by local signs of infection, and usually presents as unexplained fever. The diagnosis should be considered only after other causes of fever have been ruled out. The likelihood of fever being due to i.v.-line infection increases with duration of i.v. catheterization. Skin organisms (i.e., Staphylococcus epidermidis/coagulase-negative staphylococci, and to a lesser extent, Staphylococcus aureus) are the usual pathogens in i.v.-line infection. Treatment of i.v.-line infection involves removal of the i.v. line/device. Empiric antibiotic therapy directed against gram-positive cocci/aerobc gram-negative bacilli is usually started after blood cultures have been obtained and the removed catheter tip sent for semiquantitative culture.