Peritoneal Dialysis•9 min read

PD exit-site at tunnel infection: pamumula, nana, sakit at kailan kailangang magpatingin

Hindi lahat ng PD infection ay peritonitis. Puwede ring magsimula sa skin exit site o sa tunnel ng catheter sa ilalim ng balat. Early review is important because catheter-related infection can progress and can be associated with peritonitis.

Checked September 25, 2026Clinical guidance + educational explanation

Important

Antibiotic choice and duration for PD catheter-related infection must be prescribed by the treating team and adjusted to cultures/clinical response. Do not self-treat with leftover oral or topical antibiotics.

Exit-site infection vs tunnel infection

Exit-site infection involves the skin where the PD catheter comes out. Tunnel infection involves the catheter tract under the skin and may cause pain, swelling, redness or a collection along that path.

These infections are clinically different from peritonitis, but they can occur together or increase the risk of deeper infection.

Mga signs na kailangang ipa-check

✓Pus or purulent drainage from the exit site.

✓Increasing redness, warmth or swelling.

✓New or worsening pain or tenderness.

✓Skin becoming hard or inflamed around the catheter.

✓Tenderness, swelling or redness extending along the catheter tunnel.

✓Fever or feeling unwell.

✓Cloudy PD effluent or abdominal pain at the same time.

Ano ang puwedeng gawin ng PD team?

The team may examine the exit site and tunnel, take a swab or culture when appropriate, and review prior organisms or antibiotic exposure. Ultrasound can sometimes be used when tunnel involvement is suspected.

Antibiotic selection depends on likely bacteria, culture results, prior MRSA/Pseudomonas history, allergies and local resistance patterns.

Bakit hindi dapat basta topical cream lang?

A true catheter-related infection may need systemic antibiotic treatment and close follow-up. The 2023 ISPD guideline emphasizes clinical monitoring because treatment duration can vary by organism and response.

Do not assume that redness or drainage can be managed by adding extra ointment, alcohol, peroxide or an old antibiotic cream.

Kailan nagiging mas concerning?

Infection that does not improve with appropriate treatment, Pseudomonas infection, clear tunnel involvement, or infection occurring together with peritonitis can require more aggressive management.

In selected refractory cases, catheter interventions or removal may be considered by the PD/nephrology team. This is a clinical decision—not something the patient should delay or decide based on appearance alone.

Habang naghihintay ng assessment

✓Keep the site clean and protected using the technique your PD team already taught you.

✓Do not squeeze pus or probe the tunnel.

✓Do not cut, reposition or aggressively manipulate the catheter.

✓Do not use unprescribed antiseptics or antibiotics.

✓If cloudy effluent or abdominal pain appears, report it immediately because peritonitis may also be present.

Urgent warning signs

Exit-site pus, spreading redness, tunnel pain/swelling, fever, or any catheter infection with cloudy effluent/abdominal pain should be reported promptly to the PD team.