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Localized infection — Clinical Guidelines

Overview

Localized infection refers to infections confined to specific anatomical regions, often requiring targeted diagnostic and therapeutic approaches to prevent systemic spread. 59

Diagnosis

Clinical Presentation: Localized signs and symptoms such as redness, swelling, warmth, and pain at the site of infection. 59

Laboratory Tests: Elevated white blood cell count and C-reactive protein levels may indicate infection. 59

Imaging: Ultrasound or other imaging modalities can help identify the extent and location of infection. 9 21

Culture and Sensitivity: Obtain cultures from the infected site to identify pathogens and guide antibiotic therapy. 59

Management

Antibiotics: Initiate broad-spectrum antibiotics based on local resistance patterns and culture results, then narrow as needed. 59

Source Control: Remove or manage the source of infection (e.g., infected catheters, abscess drainage). 59 28

Supportive Care: Manage symptoms and complications, including fluid resuscitation and pain control. 59

Monitoring: Regularly monitor vital signs and laboratory parameters to assess response to treatment. 59

Special Populations

Pediatrics: Ultrasound guidance is crucial for safe central venous catheter placement in children to minimize complications. 24 26

Elderly: Increased vigilance for complications such as central line-associated bloodstream infections (CLABSI) and thrombosis. 59

Comorbidities: Patients with malignancies or compromised immune systems require tailored management to address VTE risks and infection control. 2 13 17

Key Recommendations

Use Ultrasound Guidance for Central Venous Catheter Placement to reduce complications and improve success rates. (Evidence: Strong 9 10 16 21 25 35)

Avoid Routine Chest X-rays Post-Procedure for central venous catheter placement unless clinically indicated, to reduce unnecessary radiation exposure. (Evidence: Moderate 20 44 54)

Implement Simulation-Based Training for procedural skills like central venous catheter insertion to enhance competency and reduce complications. (Evidence: Strong 7 8 27 44)

Ensure Source Control by promptly addressing and removing infectious sources to prevent systemic spread. (Evidence: Strong 59 28)

Tailor Antibiotic Therapy based on culture and sensitivity results to optimize efficacy and minimize resistance. (Evidence: Moderate 59)

References

1 De Cassai A, Maggiolo A, Mormando G, Vittadello A, Borio G, Ruopolo C et al.. The role of ultrasound monitor positioning in internal jugular vein catheterization: A randomized clinical trial on ergonomic optimization. The journal of vascular access 2026. link 2 Villalobos A, Valle R, Pagán-Escribano J, Ortiz M, Demelo-Rodríguez P, Font C. 2024 Spanish Society of Internal Medicine (SEMI) recommendations for the management of cancer-associated venous thromboembolism. Revista clinica espanola 2025. link 3 Slosse C, Roche A, Hossu G, Fantin L, Amouyal N, Hani H et al.. Benefits of simulation for ultrasound-guided midline placement training: MC-in-Sim pilot study. The journal of vascular access 2025. link 4 Miyazaki A, Fujii A, Kuwabara D, Minoguchi K, Kawakami H, Nakamura K et al.. Enhancing the quality and safety of central venous catheter insertion using projection mapping: a prospective observational simulation study with eye-tracking glasses. BMJ open 2025. link 5 Weinstein JL, Ali H, Mitchell JD, Sarwar A, Palmer MR, MacLellan C et al.. Analyzing the Evolution of Needle and Ultrasound Probe Manipulation Skills of Interventional Radiology Trainees With Time and Experience. Simulation in healthcare : journal of the Society for Simulation in Healthcare 2025. link 6 Takashima M, Ezure Y, Furuya-Kanamori L, Wolf J, Dufficy M, Gibson V et al.. Pediatric Central Venous Access Device Lock Solutions: A Network Meta-analysis. Pediatrics 2024. link 7 Savir S, Khan AA, Yunus RA, Gbagornah P, Levy N, Rehman TA et al.. Virtual Reality Training for Central Venous Catheter Placement: An Interventional Feasibility Study Incorporating Virtual Reality Into a Standard Training Curriculum of Novice Trainees. Journal of cardiothoracic and vascular anesthesia 2024. link 8 Corvetto MA, Kattan E, Ramírez G, Besa P, Abbott E, Zamorano E et al.. Simulation-Based Training Program for Peripherally Inserted Central Catheter Placement: Randomized Comparative Study of in-Person Training With Synchronous Feedback Versus Distance Training With Asynchronous Feedback. Simulation in healthcare : journal of the Society for Simulation in Healthcare 2024. link 9 Žarskus A, Zykutė D, Trepenaitis D, Macas A. Implementation of Ultrasound-Guided Infraclavicular Subclavian Venous Catheterization During Anesthesia and Elective Surgery: A Prospective Observational Study at a Single Center in Lithuania. Medical science monitor : international medical journal of experimental and clinical research 2023. link 10 Rivera D, Hutto EDG, Crimi E, Simmons VC. Improved Technical Skill and Procedure Time With Central Venous Catheter Simulation. AANA journal 2023. link 11 Baribeau V, Sharkey A, Murugappan KR, Walsh DP, Wong VT, Bose A et al.. Assessing Skill Acquisition in Anesthesiology Interns Practicing Central Venous Catheter Placement Through Advancements in Motion Analysis. Journal of cardiothoracic and vascular anesthesia 2022. link 12 Blanie A, Shoaleh C, Marquion F, Benhamou D. Comparison of multimodal active learning and single-modality procedural simulation for central venous catheter insertion for incoming residents in anesthesiology: a prospective and randomized study. BMC medical education 2022. link 13 Nachar VR, Schepers AJ. Clinical controversies in the treatment of cancer-associated venous thromboembolism. Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners 2021. link 14 Reis J, Koo KSH, Shivaram GM, Shaw DW, Monroe EJ, Iyer RS. Time-Driven Cost Analysis of Noncuffed Venous Catheter Placement in Infants: Bedside versus IR Suite. Journal of vascular and interventional radiology : JVIR 2021. link 15 Tozer J, Vitto MJ, Joyce M, Taylor L, Evans DP. Central Venous Catheter Confirmation by Ultrasonography: A Novel Instructional Protocol. Southern medical journal 2020. link 16 Al Aseri ZA, Al Hussein RM, Malabarey MA, AlYahya BA, Al Moaiqel FA, Al Ansari MA et al.. Use of ultrasound guidance in central venous catheter placement by emergency physicians in Saudi Arabia. Saudi medical journal 2020. link 17 Kraaijpoel N, Carrier M. How I treat cancer-associated venous thromboembolism. Blood 2019. link 18 Ablordeppey EA, Drewry AM, Theodoro DL, Tian L, Fuller BM, Griffey RT. Current Practices in Central Venous Catheter Position Confirmation by Point of Care Ultrasound: A Survey of Early Adopters. Shock (Augusta, Ga.) 2019. link 19 Scholten HJ, Ten Bloemendal E, Botter B, Korsten HHM, Bouwman RA. Barriers to ultrasound guidance for central venous access: a survey among Dutch intensivists and anaesthesiologists. Journal of clinical monitoring and computing 2019. link 20 Woodland DC, Randall Cooper C, Farzan Rashid M, Rosario VL, Weyker PD, Weintraub J et al.. Routine chest X-ray is unnecessary after ultrasound-guided central venous line placement in the operating room. Journal of critical care 2018. link 21 Sappenfield JW, Smith WB, Cooper LA, Lizdas D, Gonsalves DB, Gravenstein N et al.. Visualization Improves Supraclavicular Access to the Subclavian Vein in a Mixed Reality Simulator. Anesthesia and analgesia 2018. link 22 Clements W, Sneddon D, Kavnoudias H, Joseph T, Goh GS, Koukounaras J et al.. Randomized and controlled study comparing patient controlled and radiologist controlled intra-procedural conscious sedation, using midazolam and fentanyl, for patients undergoing insertion of a central venous line. Journal of medical imaging and radiation oncology 2018. link 23 Hartman N, Wittler M, Askew K, Hiestand B, Manthey D. Validation of a performance checklist for ultrasound-guided internal jugular central lines for use in procedural instruction and assessment. Postgraduate medical journal 2017. link 24 He C, Vieira R, Marin JR. Utility of Ultrasound Guidance for Central Venous Access in Children. Pediatric emergency care 2017. link 25 Corvetto MA, Pedemonte JC, Varas D, Fuentes C, Altermatt FR. Simulation-based training program with deliberate practice for ultrasound-guided jugular central venous catheter placement. Acta anaesthesiologica Scandinavica 2017. link 26 Miller R, Ho H, Ng V, Tran M, Rappaport D, Rappaport WJ et al.. Introducing a Fresh Cadaver Model for Ultrasound-guided Central Venous Access Training in Undergraduate Medical Education. The western journal of emergency medicine 2016. link 27 Cartier V, Inan C, Zingg W, Delhumeau C, Walder B, Savoldelli GL. Simulation-based medical education training improves short and long-term competency in, and knowledge of central venous catheter insertion: A before and after intervention study. European journal of anaesthesiology 2016. link 28 Collin G, Jones RG, Willis AP. Central venous obstruction in the thorax. Clinical radiology 2015. link 29 McSparron JI, Ricotta DN, Moskowitz A, Volpicelli FM, Roberts DH, Schwartzstein RM et al.. The PrOSTE: identifying key components of effective procedural teaching. Annals of the American Thoracic Society 2015. link 30 Clinkard D, Holden M, Ungi T, Messenger D, Davison C, Fichtinger G et al.. The development and validation of hand motion analysis to evaluate competency in central line catheterization. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2015. link 31 Faulke DJ, Hall TH, Nixon C. Electromagnetic needle tracking during simulated right internal jugular cannulation. Anaesthesia and intensive care 2015. link 32 Ferre RM, Mercier M. Novel ultrasound guidance system for real-time central venous cannulation: safety and efficacy. The western journal of emergency medicine 2014. link 33 Buchanan MS, Backlund B, Liao MM, Sun J, Cydulka RK, Smith-Coggins R et al.. Use of ultrasound guidance for central venous catheter placement: survey from the American Board of Emergency Medicine Longitudinal Study of Emergency Physicians. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2014. link 34 Seo H, Jang DM, Yi JM, Min HG, Hwang JH. The accuracy of the new landmark using respiratory jugular venodilation and direct palpation in right internal jugular vein access. PloS one 2014. link 35 Mehta N, Valesky WW, Guy A, Sinert R. Systematic review: is real-time ultrasonic-guided central line placement by ED physicians more successful than the traditional landmark approach?. Emergency medicine journal : EMJ 2013. link 36 Vieira RL, Gallagher RA, Stack AM, Werner HC, Levy JA. Development and evaluation of a program for the use of ultrasound for central venous catheter placement in a pediatric emergency department. Pediatric emergency care 2013. link 37 Moureau N, Lamperti M, Kelly LJ, Dawson R, Elbarbary M, van Boxtel AJ et al.. Evidence-based consensus on the insertion of central venous access devices: definition of minimal requirements for training. British journal of anaesthesia 2013. link 38 Ball RD, Scouras NE, Orebaugh S, Wilde J, Sakai T. Randomized, prospective, observational simulation study comparing residents' needle-guided vs free-hand ultrasound techniques for central venous catheter access. British journal of anaesthesia 2012. link 39 Latif RK, Bautista AF, Memon SB, Smith EA, Wang C, Wadhwa A et al.. Teaching aseptic technique for central venous access under ultrasound guidance: a randomized trial comparing didactic training alone to didactic plus simulation-based training. Anesthesia and analgesia 2012. link 40 Matava C, Hayes J. A survey of ultrasound use by academic and community anesthesiologists in Ontario. Canadian journal of anaesthesia = Journal canadien d'anesthesie 2011. link 41 Matera JT, Egerton-Warburton D, Meek R. Ultrasound guidance for central venous catheter placement in Australasian emergency departments: potential barriers to more widespread use. Emergency medicine Australasia : EMA 2010. link 42 Wadman MC, Lomneth CS, Hoffman LH, Zeger WG, Lander L, Walker RA. Assessment of a new model for femoral ultrasound-guided central venous access procedural training: a pilot study. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2010. link 43 Krombach GA, Plumhans C, Goerg F, Günther RW. Central vein dilatation prior to concomitant port implantation. Cardiovascular and interventional radiology 2010. link 44 Barsuk JH, McGaghie WC, Cohen ER, O'Leary KJ, Wayne DB. Simulation-based mastery learning reduces complications during central venous catheter insertion in a medical intensive care unit. Critical care medicine 2009. link 45 Woo MY, Frank J, Lee AC, Thompson C, Cardinal P, Yeung M et al.. Effectiveness of a novel training program for emergency medicine residents in ultrasound-guided insertion of central venous catheters. CJEM 2009. link 46 McGrattan T, Duffty J, Green JS, O'Donnell N. A survey of the use of ultrasound guidance in internal jugular venous cannulation. Anaesthesia 2008. link 47 Mansour M, Kamper L, Altenburg A, Haage P. Radiological central vein treatment in vascular access. The journal of vascular access 2008. link 48 Tovey G, Stokes M. A survey of the use of 2D ultrasound guidance for insertion of central venous catheters by UK consultant paediatric anaesthetists. European journal of anaesthesiology 2007. link 49 Gebauer B, Teichgräber UK, Podrabsky P, Werk M, Hänninen EL, Felix R. Radiological interventions for correction of central venous port catheter migrations. Cardiovascular and interventional radiology 2007. link 50 Milling T, Holden C, Melniker L, Briggs WM, Birkhahn R, Gaeta T. Randomized controlled trial of single-operator vs. two-operator ultrasound guidance for internal jugular central venous cannulation. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2006. link 51 Molgaard O, Nielsen MS, Handberg BB, Jensen JM, Kjaergaard J, Juul N. Routine X-ray control of upper central venous lines: Is it necessary?. Acta anaesthesiologica Scandinavica 2004. link 52 Teichgräber UK, Gebauer B, Benter T, Wagner HJ. Central venous access catheters: radiological management of complications. Cardiovascular and interventional radiology 2003. link 53 Vesely TM. Central venous catheter tip position: a continuing controversy. Journal of vascular and interventional radiology : JVIR 2003. link 54 Sanabria A, Henao C, Bonilla R, Castrillón C, Cruz H, Ramírez W et al.. Routine chest roentgenogram after central venous catheter insertion is not always necessary. American journal of surgery 2003. link00122-3) 55 Miller AH, Roth BA, Mills TJ, Woody JR, Longmoor CE, Foster B. Ultrasound guidance versus the landmark technique for the placement of central venous catheters in the emergency department. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2002. link 56 Reeves AR, Seshadri R, Trerotola SO. Recent trends in central venous catheter placement: a comparison of interventional radiology with other specialties. Journal of vascular and interventional radiology : JVIR 2001. link61681-9) 57 Tierney SN, Katke J, Langer JC. Cost comparison of electrocardiography versus fluoroscopy for central venous line positioning in children. Journal of the American College of Surgeons 2000. link00316-1) 58 Caridi JG, West JH, Stavropoulos SW, Hawkins IF. Internal jugular and upper extremity central venous access in interventional radiology: is a postprocedure chest radiograph necessary?. AJR. American journal of roentgenology 2000. link 59 Vrazas JI. Central venous catheter placement. Hospital medicine (London, England : 1998) 1999. link 60 Morello FP, Donaldson JS, Saker MC, Norman JT. Air embolism during tunneled central catheter placement performed without general anesthesia in children: a potentially serious complication. Journal of vascular and interventional radiology : JVIR 1999. link70114-4) 61 Lucey B, Varghese JC, Haslam P, Lee MJ. Routine chest radiographs after central line insertion: mandatory postprocedural evaluation or unnecessary waste of resources?. Cardiovascular and interventional radiology 1999. link 62 Corsten SA, van Dijk B, Bakker NC, de Lange JJ, Scheffer GJ. Central venous catheter placement using the ECG-guided Cavafix-Certodyn SD catheter. Journal of clinical anesthesia 1994. link90086-8) 63 Gibson RN, Hennessy OF, Collier N, Hemingway AP. Major complications of central venous catheterisation: a report of five cases and a brief review of the literature. Clinical radiology 1985. link80125-2) 64 Ratcliffe FM. Suppurative thrombosis of the superior vena cava: a lethal complication of central venous catheters. Intensive care medicine 1985. link 65 Drabinsky M. Retrieval of embolized central venous catheters by a Dormia ureteral stone dislodger with straight filiform tip. Chest 1976. link

Localized infection