Complications associated with PICC lines include central line-associated bloodstream infections (CLABSI), improper tip placement, and extravasation of the catheter, among others. A fever may indicate a CLABSI. Improper tip placement into the right atrium can lead to supraventricular tachycardia due to irritation of the cardiac cells. Muffled heart sounds indicate a pericardial effusion which can be caused by extravasation of the catheter through the wall of the heart and into the surrounding pericardial sac. Gentamicin is ototoxic and nephrotoxic; therefore, tinnitus and decreased urine output are likely complications of gentamicin rather than the PICC line. Swelling of the lips and tongue indicate an anaphylactic reaction; this might be caused by an allergy to the oxacillin rather than the PICC line.