Pt presented to er with infected avf ((b)(6) 2016).Redness, swelling, heavy discharge, pain for past 2 days.She said the pain and drainage started a little while after dialysis had accessed the fistula.It got progressively worse until she presented to er.Blood cultures positive.She was taken to surgery the next day and the lower (arterial) v-wing was removed, sent to pathology.It tested (b)(6), as did the blood cultures.She is still hospitalized.Being treated with vancomycin, flagyl, meropenem, and cipro.Has since developed c.Diff and gets a little more confused every day, though ct and mri of brain are negative for ischemia.They have not been able to access the avf successfully yet.Currently dialyzing through femoral access.Avf has palpable thrill and bruit audible, but still have been unsuccessful at cannulating.
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