<s>[INST] My sister has hemodialysis with a shunt in her neck.  Where it is inserted is incredibly itchy and has red spots.  The itch is horrible and she cant even sleep. Its located right where the shunt is inserted.  Any ideas or questions she should ask her dr?  She doesnt think she has a latex allergy.   Thanks.  Please reply to  YYYY@YYYY . [/INST] Respected sir/madamThanks for writing to us. Itching with red spots at the site of shunt formation indicates either allergy to some component used in the process or early infection. Since the consequences of an infection at this site will be awful, it would be prudent to get it evaluated by the concerned physician who has done the procedure. Presence of fever or feeling of loss of well-being favors infection over allergy. Sincerely </s>