امرأة عمرها ٥٧ سنة على غسيل كلوي عبر قسطرة وريدية مركزية في الرقبة. بعد بدء الجلسة بنصف ساعة صارت عندها رجفة وحرارة ٣٩٫١، والضغط نزل إلى ٩٢/٥٤، والنبض ١٢٠. مكان القسطرة محمر قليلاً. ما الإجراء المتوقع؟

A 57-year-old woman on haemodialysis via a neck central catheter develops rigors and fever 39.1 °C half an hour into the session; BP falls to 92/54, HR 120. The exit site is slightly red. What is expected?

1. Complete the full session, then give an oral antipyretic afterwards
2. Stop the session, take blood cultures and start antibiotics
3. Increase the dialysis rate to finish the session sooner
4. Cover the site with a new dressing and review tomorrow

Answer: B) Stop the session, take blood cultures and start antibiotics. Fever and rigors during dialysis via a central catheter suggest catheter-related bloodstream infection until proven otherwise. Cultures from line and vein are taken, antibiotics started and the line may be removed.