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Infections occur in up to 8-9% of ICD sites. Early infections usually occur within the first 2 months of placement and are associated with typical findings...redness, tenderness, systemic symptoms, etc. Late infections, however, are often associated with nothing more than JUST pain.
Lack of diagnosis of ICD site infections is associated with a mortality > 50%.
When infected, the entire ICD (including wires) must be replaced.
The most commor organisms associated with ICD infections are Staph and Strep. Treat them all with vancomycin.