The Utility of Ultrasound to Diagnose Tunnel-Tract Infection Related to Indwelling Pleural Catheters.

Indwelling pleural catheter (IPC) infections lead to increased morbidity and treatment failure in patients with chronic recurrent pleural effusions. Ultrasonography is a readily available diagnostic tool used by pulmonologists on a daily basis. Ultrasonography has been used to identify the etiology of indwelling peritoneal catheter obstruction, including infection of the exit site and tunnel tract. The use of ultrasonography to identify tunnel-tract infection involving IPC has not been reported. We describe the ultrasonographic characteristics of 3 cases of confirmed tunnel-tract infection and compared them with noninfected chronic IPCs. Ultrasonographic evaluation of the soft tissue tunnel tract can accurately identify fluid collections around the catheter and cuff, which is highly suggestive of tunnel-tract infection.