A 55-year-old obese male with dysuria and hypotension was admitted to the ICU 12 hours previously. He had a femoral central venous catheter inserted in the Emergency Department on admission. Your registrar has reported that blood cultures collected through the CVC at the time of insertion growing Staphylococcus epidermidis.
a)
Not to give additional antibiotics
Consider removing / re-siting the femoral CVC depending on the patient’s condition
b)
Key points about the first part of this question:
Key points about the risk factors for clinically significant S.epidermidis bacteraemia:
In any case, the question clearly points our way to urosepsis. The guy had dysuria, which is not usually a feature of staphylococcal endocarditis so severe that it would cause haemodynamic collapse and ICU admission.
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