Which of the following are common signs of an exit-site infection?

• A. Redness, tenderness, and/or purulent drainage at the catheter exit site
• B. Nodule formation along the tracts of the peritoneal catheter
• C. Fever and generalized malaise without exit-site findings
• D. Hypertension and weight gain

Answer: (A)

Exit-site infection is a local infection at the PD catheter exit. The hallmark signs are redness around the exit, tenderness on palpation, and purulent drainage from the exit site. These findings show the skin and subcutaneous tissues around the catheter exit are infected, which is the key clue in this scenario. Recognizing these local signs early helps prevent the infection from spreading along the catheter tunnel or into the peritoneal cavity.

Nodule formation along the catheter tract suggests a different issue, typically a tunnel infection. Fever and generalized malaise without exit-site findings point to a systemic illness that may not be localized to the exit site, such as peritonitis or another infection. Hypertension and weight gain are not signs of an exit-site infection.