posted
I've been monitoring myself all day now and I've had a temperature on and off, shaking, fever and chills. Don't know what to do. It's now 102.4.
I think I have the flu as my sister had it. I'm taking tylenol every 4 hours and it seems to take the temp down below 100. I don't want to loose my PICC if I go to the emergency room.
What can I do?
Posts: 20 | From Saratoga Springs, NY | Registered: Mar 2009
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posted
Just took temp its 101.6
Posts: 20 | From Saratoga Springs, NY | Registered: Mar 2009
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Abxnomore
Frequent Contributor (5K+ posts)
Member # 18936
posted
Do you have any shortness of breath, swelling or closing of the throat, pain at the picc site, or pain running down your arm?
When was the dressing last changed? Did the site look fine then?
It's always a hard call with these things but if your sister had a temp, shakes and chills with her flu and you don't have any other symptoms that might indicate infection of your picc line, it just might be a flu you picked up from her.
Can you call your home nursing service?
Posts: 5191 | From Lyme Zone | Registered: Jan 2009
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posted
I did call my nursing service and my dr. they said to monitor the temperature and if I started vomitting or the temp went above 103 to go to the ER. I do have lymph nodes swelling and really bad aches and pains all over
No problems with the PICC, no redness or swelling. And, I infused myself today just fine.
Posts: 20 | From Saratoga Springs, NY | Registered: Mar 2009
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posted
Dressing was changed on 8/12. I did add Bactrim to my abx list because of Serratia in my lungs. Dr. gave me a sputum test and found the Serratia - he said it was rare to find the infection.
Posts: 20 | From Saratoga Springs, NY | Registered: Mar 2009
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merrygirl
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posted
serratia can go in your blood please be careful
Posts: 3905 | From USA | Registered: May 2007
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Dawn in VA
Frequent Contributor (1K+ posts)
Member # 9693
posted
I hope you start to feel better very soon.
Merrygirl is right. From what I just looked up, it can affect several organs and bloodstream.
General info ~ respiratory type:
"Sepsis: Patients with Serratia sepsis may present with fever, chills, shock, and respiratory distress.
Serratia pneumonia may develop, but this is rare. Patients with pneumonia may have fever, chills, productive cough (sometimes with pseudohemoptysis6 ), hypotension, dyspnea, and/or chest pain."
"Sepsis or bacteremia Placement of intravenous, intraperitoneal, or urinary catheters and prior instrumentation of the respiratory tract have been identified as risk factors among inpatients."
The primary medical treatment for patients with S. marcescens infections is antibiotic therapy. S.
marcescens is resistant to ampicillin, macrolides, and first-generation cephalosporins. Treatment for the bacterium includes the use of an
antipseudomonal beta-lactum and an aminoglycoside. Amikacin works against most strains of S. marcescens, but there are reports of growing
resistance to gentamicin and tobramicin. Most strains of S. marcescens are susceptible to quinolones as well. Antibiotic therapy should be
based upon the results of susceptibility testing because there are strains that are multiresistant.
-------------------- (The ole disclaimer: I'm not a doctor.) Posts: 1349 | From VA | Registered: Jul 2006
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WildCondor
Unregistered
posted
Go to the ER, have them culture your blood from both the PICC line, and from your other arm. If the fever doesn't go away, get the line pulled for safety. You don't want to mess around with sepsis. PICC lines can carry bacteria that when it spreads to the blood can be deadly VERY fast. Shaking chills is a big sign of sepsis, so is the pain all over. Sure it COULD be the flu, I don't know, but it's better to be safe and go get checked out and have them check or pull that PICC line. If they pull it, have them culture the tip, the culture will take 24-48 hours, they might put you on Cipro until the results come in. Let us know how it goes. You can always get another PICC line if it is in fact, sepsis.
posted
The Shock of Your Life: The Hidden Dangers of IV Lines
by WildCondor
Imagine yourself outside on a bright sunny day. You are sitting on your back deck enjoying the outdoors, feeling content and thankful that you have made it this far. You finally received a Lyme disease diagnosis after years of misdiagnosis and a wild goose chase, and the whole confusing and maddening influx of clueless doctors that comes with it. You just got your new PICC line, and you are all set to finally start your IV antibiotics for Lyme disease. You are pretty nervous and overwhelmed at the entire thing, but you are glad to finally be getting the treatment you have needed for months or years.
You do your first 6 weeks of IV antibiotics and everything goes smoothly. You herx pretty hard in the beginning, and that is a normal and expected reaction. All your symptoms get worse, and you even notice some new ones popping up that you never had before. You may feel like you are dying at times because your body is overwhelmed with toxins and killing bacteria.
You keep going with your treatment, taking special care to keep your IV line clean and dry. You hope you won't need it for too much longer, but you are still so sick, you know you will need it for a while longer.
Then one morning you wake up, and flush your IV line with saline, and prepare your IV antibiotic for administration. You've done this hundreds of times by now, so it has become a normal part of your daily routine. Unfortunately, this IV treatment will be different, unlike any other. As you flush the line with saline, you notice your hand starts hurting, and you suddenly feel sick to your stomach. Almost instantaneously, you begin to feel sick all over your body, you start to sweat and you feel funny in the head. A minute goes by, you start to vomit, and you feel like something is taking over your entire body. You grab a thermometer out of your drawer, and much to your alarm, it reads 103.9 degrees! In a panic, you check it again. This time it's measuring off the end limit at 104.7 degrees and climbing.
You start to throw up all over yourself and your heart is racing so fast you cannot catch your breath. Your entire body is shaking violently and you know something terrible is happening. In a panic, you dial 911, and then pass out. The ambulance comes to save you, and they find you near death with a blood pressure of 240/110 and a heart rate of 165. They treat you for shock, and see the IV line sticking out of your arm. You don't know any of this is happening because you are unconscious.
What's happening to you is called septic shock. It's also known as bacteremia, or sepsis. Bacteremias are life-threatening infections of the bloodstream. When bacteria enter a central line (PICC line, chest port, Hickman, Groshong, etc.) they can reproduce in the line and can cause a fatal blood infection. When this happens, you are referred to as a "septic" patient. Immediate treatment is necessary to save your life. If you become "septic," you will likely be so sick and out of it that you are considered to be in "septic shock". Sepsis can develop as a result of your body's immune system defenses, or from the toxic substances made by the infecting agent (such as a bacteria, virus, or fungus). Many different microbes can cause sepsis. Although bacteria are most commonly the cause, viruses and fungi can also cause sepsis.
To all of you who have IV lines, your doctor may or may not have warned you about the dangers of having a central line. Oftentimes patients are coached on how to administer their IV antibiotics, how to flush the line with saline solution and heparin to prevent clotting of the blood in the line. Most PICC line users know how to change the dressing, how to shower with the PICC line, and how to be gentle with it. What many patients do not know, is what to do if that line ever gets infected. Most doctors do not routinely explain what to do if you become septic because it would likely scare the patient quite badly. Most vascular surgeons, (the guys who operate on you to insert the central line) also do not explain what to do if it gets infected, when to remove the line, or what to do if it ever leaks, etc.
As a Lyme disease patient, and a two-time septic shock survivor, I am here to share my experience with the dangers of IV lines. This is only meant to help educate you, and this is not the ranting of some anti-intravenous Lyme victim. Trust me, I am all for aggressive antibiotic therapy and IV, so please try not to get the wrong impression. I am not a doctor, so please do not take any of the following as medical advice.
Please follow up with your personal physician and ask your own questions. Please consider these words to be a warning based on a patient's experience. I'm putting this out there to hopefully help save some lives, and arm you with the information about what to do if an emergency ever strikes.
In a nutshell, if you are on IV, or going to be on IV, know the risks in advance. Be prepared. Have your doctor's emergency contact information plugged into your cell phones and on a notepad next to your home phone. Give your family and caretakers your doctors' phone number, and pager. Inquire in advance if your doctor has a pager, cell phone or answering service, and ask him/her what you should do if you ever have an IV line emergency. Another tip I have to offer is to always do your IV treatments during your doctor's office hours so you can quickly call them if something comes up. It's also a good idea to make sure somebody is home with you, keeping an eye on you while you administer your treatment. At the very least, make sure you have a phone near you when doing your IV. Always go for your routine blood work while you are on IV and be extra careful during all of your social activities. Many of you travel long distances to see your LLMD, sometimes to other states and far from the comfort of your home. Remember, this is the very reason (one of them at least) why your LLMD requires you to have a local physician following your care, so you can call him/her in a situation like this.
Always make sure you keep your IV line clean. Learn how to change your own dressing, and always use sterile technique, which includes wearing a mask every time. Keep your dressing dry, and do not traumatize or abuse the line in any way by overexerting yourself.
If you ever notice a funny feeling during or after an IV infusion, call your doctor. If you ever feel pain all over your body, in the PICC line itself, or on your central line site, then stop the treatment, and call your doctor. If you ever encounter resistance while trying to flush your line, stop! There may be a blood clot in the line, which needs emergency medical treatment. Remember that central lines go directly into your heart, so it is not a wise idea to force the IV into your body. Stop, and think!
If you ever notice swelling, discoloration, discharge of pus, bleeding, or oozing from your IV line site, then call your doctor and go to the nearest Emergency room. If you ever have any of the above problems, plus a sudden fever, shaking chills, sudden pain all over your body, vomiting, etc, then dial 911. You don't have time to drive to the emergency room, so call the ambulance!
Your medical and hospital staff should probably pull out your central line for your own safety. If things are uncertain, and the medical professionals are not sure whether or not you have sepsis, then they should take blood cultures out of the IV line and find out if there are any harmful organisms in your IV line. Unfortunately, blood cultures take 24-48 hours to grow, so it may be wise for the ER to pull out your IV line, culture the tip of it, and start you on prophylactic sepsis treatment regardless. From what I learned as a patient, blood cultures should always be drawn regardless of whether the line is pulled or not in order to determine which organism is involved, and the resulting appropriate treatment.
When I had sepsis the first time, I had blood cultures drawn both out of the IV line, and a separate set out of my other arm for comparison. Both of the cultures showed a gram negative, very nasty bacteria that would have killed me had I waited and not gotten to the emergency room by ambulance. By the time I reached the ER, I was unconscious and my temperature was 106.7 degrees. Somehow in my delirium I managed to spit out my LLMD's phone number, and the EMT's patched him through.
The line was pulled, the tip of the line cultured, and I was placed on IV Vancomycin to kill the deadly bacteria. The second time, the same thing happened (cause unknown) and IV Cipro� was used. Let's just say that having sepsis was the scariest thing to ever happen to me, and it was absolutely astounding how fast it came on. Be extra careful with your IV lines; know the risks and the dangers and what to do! Each person is different, as is each case. The first time, I had extremely high fever and blood pressure. The second time, on a new Hickman catheter, I had very low blood pressure and fainted, but did again have a high fever and was rushed to the ER by ambulance both times.
Remember that just as there is a risk of not treating Lyme disease or Cancer, there is equal if not greater risk of using IV therapy.
Severe sepsis is a very serious, life-threatening condition. Simply put, it kills people. If you are a victim of severe sepsis, your organs will likely not receive enough oxygen and they may fail or shut down. When organs shut down, the body cannot function and death is possible. The most important intervention is rapid diagnosis and then prompt and appropriate treatment. For Lyme patients, if you ever have symptoms of sepsis, please do not assume that they are the same thing as a herx reaction. It may seem to you like your body is hurting all over so suddenly that it "must be a herx", and you might be tempted to push through the pain. Bad idea!
According to the Society of Critical Care Medicine, sepsis actually kills more Americans than breast cancer, colorectal cancer, pancreatic cancer and prostate cancer combined. In the U.S., it is estimated to be around 750,000 cases a year. And, mortality is about a third. So, some 250,000-300,000 die every year of sepsis. About half to two-thirds of patients in the ICU die because of severe sepsis.
Now that I have probably scared you all half to death, try to relax. Sepsis is a known risk for anybody with a central IV line, but is the exception, rather than the rule. Over the past 10 years I have emailed and spoken to hundreds of Lyme disease patients who have done IV antibiotics, and had absolutely no problems. I have also talked to a few who have had problems with their lines, such as leaks, bleeding, pain, bruising or blood clots. There have been 4 people that I know of who have gotten severe sepsis.
One of the victims was Susan, who is now a good friend of mine. At t he time, Susan was just a visitor trying to learn about Lyme disease on the internet. She later told me that if I had not publicly explained my sepsis story on a public internet Lyme disease forum, that she would have had no idea what to do when it happened to her. Sue had read one of my posts, and when she got sepsis herself from an infected Hickman catheter, she recognized the symptoms, knew what to do, and went by ambulance to the ER. She survived, and that is why I decided to write this article as a warning for all of you.
If I had to do my Lyme disease treatment all over again, I would still use IV antibiotics without hesitation. Long-term IV antibiotics saved me from a life of disability and pain and brought me back to the land of happiness and healthy, happy living.
In closing, remember this: your health is important, and most of you value it more than anything else in your life. I will leave you with one of my favorite quotes: "Don't be afraid to encounter risks. It is by taking these chances that we learn to be brave." Be brave, but do it with wisdom.
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Dawn in VA
Frequent Contributor (1K+ posts)
Member # 9693
posted
Saratoga, you mentioned that you don't want to loose your PICC if you go to the ER.
Remember that you can always get another one put in your other arm if your doc agrees.
I had one of mine withdrawn then a new inserted the very next day in the opposite arm.
I would like to encourage you to seek medical attention for what you're experiencing.
-------------------- (The ole disclaimer: I'm not a doctor.) Posts: 1349 | From VA | Registered: Jul 2006
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posted
Wild Condor, thank you so much for sharing your story. I just had my PICC removed after seven months, with no problems. But they can happen, and your story is a great reminder of that.
Posts: 374 | From United States | Registered: Nov 2008
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Tracy9
Frequent Contributor (1K+ posts)
Member # 7521
posted
This just happened to my 14 year old son three days ago. His temp reached 104 with no other symptoms but shaking chills and severe fatigue.
I took him to the ER after much ado (including re-reading Wild Condor's story above) and they pulled out his PICC line.
His blood counts showed he had an infection. They weren't high enough for him to be hospitalized, but I bet if I had waited another day he would have been.
Getting his PICC pulled seemed very minor in comparison to what could have happened. We will now get another line put in and he will resume antibiotics. Meanwhile he is thoroughly enjoying some PICC free days and showers.
GET RIGHT TO THE HOSPITAL. This can turn deadly overnight. With your symptoms, you cannot afford to wait.
13 years Lyme & Co.; Small Fiber Neuropathy; Myasthenia Gravis, Adrenal Insufficiency. On chemo for 2 1/2 years as experimental treatment for MG. Posts: 4480 | From Northeastern Connecticut | Registered: Jun 2005
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posted
You may not want to lose your picc line- but you probably don't want to lose your life either.
Posts: 365 | From Sylvania | Registered: Aug 2008
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WildCondor
Unregistered
posted
It's tough sometimes when talking about IV lines. On one hand, IV treatment is probably the best method to treat Lyme disease. On the other, there are more risks. Many LLMD's do NOT explain the warning signs of sepsis to their patients when they get a PICC line or a port. That's why I posted the story, for those who just do not know. So far, it's saved many lives.
I want to add to what Tracy said above.... it can indeed turn deadly overnight. However, when sepsis hits, it can be with no warning, and happen in seconds.
I was doing fine with my second Hickman catheter, woke up, was watching some TV. I flushed my line with saline to do my IV Zithromax, and bam...within seconds my fever went to 104, shaking chills, vomiting, pain all over my body down to the bone, heare rate flying, you name it, it happens FAST!!!!
So, it can creep up slowly, or it can come out of nowhere, so just be prepared and know the warning signs. Have a phone near your bed or wherever you do your IV in case anything ever happens, don't wait either, don't drive yourself to the hospital, don't wait for a ride, call 911.
If you aren't sure you have sepsis, and have a low fever, or any other signs, then go to the ER anyway, and have them culture blood directly from the IV line in question. At the same time have them culture blood from the other arm. This will help them determine if the line is infected (and with what germ) and if it has spread to your blood yet.
If you get the line pulled (which you should for safety) then make sure they culture the tip of the catheter. Culturing means they check your blood for the germ causing the infection, plus they run a sensitivity test to determine which antibiotic will work against that specific germ. Since it takes time to get culture and sensitivity results back the ER doctors, (and yes, even the Infectious disease docs are consulted on this topic), will usually put you on IV Cipro, IV Vancomycin or oral pills to take home until the results are back depending on how sick you are from the sepsis.
Know the signs and the risks people, it is your responsibility as a patient to know what you are dealing with.
Does that warning apply JUST to PICC lines, or for ports as well?
James
Posts: 872 | From New York City | Registered: Jun 2008
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Tracy9
Frequent Contributor (1K+ posts)
Member # 7521
posted
We got a call from the ER today; the blood they drew from the PICC line was definitely where the infection was coming from....so it was in fact a PICC infection.
I am wondering if he would be better off with a chest port; easier to keep clean and not so "out there" as his arm is?
How long should it take to recover from a PICC line infection? He seemed fine the next day, but still running close to a 100 degree fever. I let him go to Six Flags today (he never gets to go ANYWHERE) with my sister and niece and I hope he is doing okay.
13 years Lyme & Co.; Small Fiber Neuropathy; Myasthenia Gravis, Adrenal Insufficiency. On chemo for 2 1/2 years as experimental treatment for MG. Posts: 4480 | From Northeastern Connecticut | Registered: Jun 2005
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WildCondor
Unregistered
posted
James...ALL central lines can give you sepsis, anything foreign attached to the body has the potential to get infected.
Tracy a port is more like surgery to put it in. They also cannot take it out quickly if it gets infected, it has to be removed surgically, and there is more of a scar left behind on the chest. Ask Dr. J He should be on something for the sepsis if he still has a fever especially. If that bacteria is not killed off that caused the infection, and you insert a new PICC line it can happen again easily. Ask for the blood results and what the culture and sensitivity showed and the name of the organism.
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posted
First of all, I want to thank you all for your support and encouragement. I'm ok I think. But battling a very nasty - who knows! They called it febrile illness in the end. Days of nasty temps, vomitting, chills and fevers ranging from 101 up to 105.1 and its not stopping. I can't seem to eat anything without throwing up. Finally after my temp climbed to 104, I decided to drive myself to the ER to be on the safe side if nothing else test for sepsis - just to be on the safe side. The ER doctor did take blood cultures out of both of my hands to rule out sepis. They did not remove my PICC line b/c they said it looked good. They will let the cultures grow for the next 48 hours and tell me there is a problem. Had nothing to say about my serratia. I was doing well on my IV - Then my LLMD Dr. B hit the serratia with bactrim. It may be too much for my body to handle all at once. So I'm off the bactrim - but I'm still sick as a dog. Do others get sick like this 3 weeks into IV treatment?
Posts: 20 | From Saratoga Springs, NY | Registered: Mar 2009
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posted
Went to my Rheumatologist yesterday, said it could possibly be serratia pneumonia! They are waiting until Friday to because the blood culture is brewing till getting final results. He said that sometimes the body just rejects the PICC and since I have riggers it's the PICC line, but he's going to wait to discuss it with my LLMD before they pull it. Temp is 103.4 this morning and vomitting. Going to the LLMD and will report back when over with. I'm exhausted from all the fever, vomitting and chills for 5 days now!
Posts: 20 | From Saratoga Springs, NY | Registered: Mar 2009
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Dawn in VA
Frequent Contributor (1K+ posts)
Member # 9693
posted
So sorry you are still having that crazy high fever and vomiting.
I hope you start to feel better really SOON.
Hugs and prayers--
-------------------- (The ole disclaimer: I'm not a doctor.) Posts: 1349 | From VA | Registered: Jul 2006
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posted
Well the final results came back and it isn't a Picc line infection. But my liver is elevated and they kept my line in but took me off the rocephin until the get additional blood work results. Went to the hemotologist b/c platelets were 88, she told me that bactrim will sometime lower your platelet count. They are now up since I've been off the Bactrim. Not one dr can tell me what this is! very frustrating. Onward and upward. Thanks, Chris
Posts: 20 | From Saratoga Springs, NY | Registered: Mar 2009
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He should be on something for the sepsis if he still has a fever especially. If that bacteria is not killed off that caused the infection, and you insert a new PICC line it can happen again easily. Ask for the blood results and what the culture and sensitivity showed and the name of the organism.
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