Is anyone familiar with the phenomenon called "septic shower"? Supposedly it comes from an implanted port that has not been accessed for some time, then when accessed, the patient develops fever, chills etc. from the flushing of whatever is in the port into the system. I have heard of it and believe it to be true, but would like some literature support, and/or wondering if anyone has something in their policy about accessing (or not) implanted ports that have not been flushed for several months. We've had 2 patients in the last couple of weeks admitted with ports that have not been accessed for 6 months. Thanks. Patty
Hi Patty, what you are seeing is the release of biofilm on the intraluminal surfaces of the catheter. The act of flushing causes this biofilm to break loose and freely float into the bloodstream. The physical signs and symptoms usually last for a short period when the patient's immune system is able to overcome this invasion. You can read about this in:
1. Ryder M. Catheter-related infections: It's all about biofilm. Topics in Advanced Practice Nursing eJournal. 2005;5(3). http://www.medscape.com/viewarticle/508109_print
2. Ryder M. The role of biofilm in vascular catheter-related infections. New Developments in Vascular Disease [Fall 2001:15-25. Available at: http://www.medpub.com/cme.htm,. Accessed February 5, 2002, 2002.
This can occur with any catheter that has been in place for longer than ~a week or so since these catheters are known to have more intraluminal biofilm than a shorter dwelling catheter. Sorry I can not help with sharing a policy but I do not believe you can avoid accessing and flushing these lines. It does not matter who or how they are flushed, the same thing will occur. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I don't believe that this is isolated to ports. In pediatric patients, we had 2 patients with PICCs exhibit the same symptoms with flushing.
Gwen Irwin
Austin, Texas