No, you should NOT continue using your PICC line with signs of infection—it requires immediate medical evaluation and likely removal.
Immediate Action Required
When a PICC line shows signs of infection such as moderate serous drainage and swelling, continuing to use it is inappropriate and potentially dangerous. 1 The presence of these symptoms suggests either a local exit-site infection or potentially a more serious catheter-related bloodstream infection that requires urgent assessment.
Signs That Mandate Evaluation
- Moderate serous drainage from the exit site indicates active inflammation or infection that cannot be ignored 1
- Swelling around the insertion site suggests local tissue involvement that may progress to more serious complications 1
- These symptoms require immediate inspection of the site, even if you have an opaque dressing that would normally not be removed 1
When PICC Removal Is Appropriate
The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) provides clear guidance on infection-related removal:
- PICC removal is rated as appropriate when bacteremia with objective evidence of line-related infection exists 1
- In the setting of suspected (but not yet confirmed) line-related infection, the decision is more nuanced and depends on clinical stability, but the catheter should not simply continue to be used without evaluation 1
- Continued treatment using an affected PICC with confirmed infection is rated as inappropriate 1
Critical Pitfall to Avoid
Never attempt to exchange the PICC over a guidewire when there are signs of local or systemic infection—this is explicitly rated as inappropriate because it can spread infection 1. Guidewire exchange is only appropriate when there are NO signs of infection 1.
What Should Happen Next
Your healthcare provider needs to:
- Visually inspect the insertion site immediately by removing any dressing to assess the extent of local infection 1
- Obtain blood cultures if catheter-related infection is suspected to guide antibiotic therapy 2
- Consider PICC removal if there is objective evidence of line-related infection, as this is the appropriate management 1
- After a line-free interval (typically 48-72 hours) and negative blood cultures, a new PICC can only be placed if there remains a valid indication for central access 1
Special Consideration for Your Chronic Condition
While you mention having a chronic condition that may necessitate ongoing vascular access:
- The need for continued access does NOT justify keeping an infected PICC in place 1
- If you have chronic kidney disease specifically, PICC lines carry additional risks including central vein stenosis that could jeopardize future dialysis access 3
- Alternative access methods (peripheral IVs, midline catheters, or a new PICC after infection clearance) should be considered based on your remaining treatment needs 1
Contact your healthcare provider immediately—do not wait for your next scheduled appointment. The presence of drainage and swelling requires same-day evaluation to prevent progression to bloodstream infection or thrombophlebitis, both of which carry significant morbidity risk 4, 5.