What should be done if the initial Gram stain is negative?
If the initial Gram stain is negative, both tissue and the lead tip should be cultured for fungi and mycobacteria. Mycobacteria and fungal stains also should be obtained on resected pocket tissue. Percutaneous aspiration of the device pocket should not be done, in general, because of the lack of adequate diagnostic yield and the theoretical risk of introducing microorganisms into the pocket site and causing device infection.