Catheter-related septic thrombophlebitis of the great central veins successfully treated with low-dose streptokinase thrombolysis and antimicrobials

Volkow, Patricia; Cornejo‐Juárez, Patricia; Arizpe-Bravo, Ana Berta; García-Méndez, Jorge; Baltazares-Lipp, Enrique; Pérez‐Padilla, Rogelio

doi:10.1186/1477-9560-3-11

Cited by 20 publications

(9 citation statements)

References 16 publications

(18 reference statements)

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“…A number of distinct clinical conditions have been identified, depending on the vessel involved, but pathogenic mechanisms tend to be similar. Despite the increased reported incidence of STP related to invasive medical devices or procedures [ 3 ], this phenomenon was not observed in the series presented. However, in two patients, use of non sterile needles for intravenous drug use was clearly a factor.…”

Section: Discussionmentioning

confidence: 81%

The Association of Septic Thrombophlebitis with Septic Pulmonary Embolism in Adults

Brenes

Goswami

2012

TORMJ

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Background: There have been an increasing number of pediatric reports of septic pulmonary embolism in the setting of septic thrombophlebitis adjacent to a primary infectious source.Methods: Retrospective review at an urban hospital. A total of five adults with a documented primary infectious source, adjacent septic thrombophlebitis and septic pulmonary embolism were identified between 2000 and 2011.Results: The predominant symptoms on presentation were fever and pleuritic chest pain, followed by chills and cough. S. aureus was the pathogen in 4 patients. Only one case had echocardiographic evidence of endocarditis. All patients received IV antibiotics and anticoagulation therapy. No new embolic events or central nervous system complications were noted.Conclusions: The triad of extrapulmonary infection, contiguous septic thrombophlebitis and septic pulmonary embolism is present in adult as well as pediatric populations. The use of systemic anticoagulation with appropriate antibiotics resulted in clinical and radiologic improvement but no significant complications.

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Section: Discussionmentioning

confidence: 81%

The Association of Septic Thrombophlebitis with Septic Pulmonary Embolism in Adults

Brenes

Goswami

2012

TORMJ

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“…Anticoagulation therapy for VTE in cancer patients has been associated with a twofold to sixfold increased risk of bleeding compared with patients without cancer. 14,15 The heightened risk for bleeding among cancer patients may be one reason why application of CDT to acute extremity DVT in cancer patients thus far has been restricted to individual case reports or small case series, [21][22][23][24][25][26][27][28] and some studies of thrombolysis in the treatment of DVT have specifically excluded cancer patients. [16][17][18] We also have noted reluctance of physicians at our institution to consider CDT of DVT in cancer patients, perhaps reflecting these concerns noted in the literature.…”

Section: Discussionmentioning

confidence: 99%

Safety of catheter-directed thrombolysis for deep venous thrombosis in cancer patients

Preece

Black

Pham

et al. 2008

Journal of Vascular Surgery

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“…Catheter-related thrombosis is a multicausal disease. The individual risk of thrombosis arising in a patient is a result of the interactions between patient characteristics (inherited and acquired risk factors) and the catheter [ 6 ]. With regard to the catheter, it does not appear that the flow-impedance effect of the catheter's slightly larger cross-sectional area (due to the balloons) contributes to the local intravascular formation of clots [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the CoolLine catheter, which contains only two cooling balloons, allows for longer indwelling times than does the Icy catheter with three cooling balloons, but with a probably lower capacity for temperature management. Septic thrombophlebitis is one of the most serious complications related to central venous catheter (CVC) use [ 6 ]. Central venous catheter-related thrombosis and central venous catheter-related infections have been reported to be associated [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Central venous catheter-related thrombosis and central venous catheter-related infections have been reported to be associated [ 7 ]. Catheter-related thromboses can become infected with persistent bacteremia; however, it has also been recognized that CVC infection increases the risk of thrombosis [ 6 ]. Concerning individual patient characteristics, prothrombotic states may play an important role in the development of CVC-related thrombosis.…”

Section: Discussionmentioning

confidence: 99%

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Catheter related venous thrombosis with cooling and warming catheters: two case reports

Prunet

Lacroix

Bordes

et al. 2009

Cases J

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IntroductionIntravascular cooling and warming catheters are among a range of proliferating technologies used for temperature control. Complications related to the use of these devices are few, and no definitive evidence has been presented thus far to indicate any differences in complication rates between these balloon catheters and other central vein catheters. We report two cases of cooling and warming catheter-related venous thrombosis. They are the both first ones report of this kind in the literature.Case presentationThe first case was a 17-year-old man admitted with severe head trauma. On day 6, he presented with severe intracranial hypertension, requiring increased medical treatment: mannitol osmotherapy, barbiturate-induced coma, and mild therapeutic hypothermia. A double-lumen Alsius CoolLine catheter was placed in the inferior veina cava via the left femoral vein and active cooling was begun. On day 10, physical examination of the left inguinal area and echo-doppler revealed catheter-related thrombophlebitis with left iliocaval vein occlusion. The second case was a 42-year-old man admitted with a severe burn. On day 2, the patient was taken to the operating room for the first staged excision of his burn wounds. A triple lumen Alsius Icy catheter was placed in the inferior vena cava via the right femoral vein and active core warming of the patient was begun. From day 2 to day 7, active core warming of the patient was maintained. On day 7, he presented with a septic thrombophlebitis. Echo-doppler revealed a 4-cm-long thrombus at the femoral catheter site with complete blood flow obstruction and blood cultures and catheter tip were positive for methicillin-resistant Staphylococcus aureus.ConclusionAlthough generally considered safe, cooling and warming catheters can be associated with mechanical complications such as catheter-related venous thrombosis. Intensivists who use these devices should be aware of this possible complication. Finally, as with any other invasive catheter, to reduce the risk of complications, the catheter should be removed promptly when no longer needed.

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Catheter-related septic thrombophlebitis of the great central veins successfully treated with low-dose streptokinase thrombolysis and antimicrobials

Cited by 20 publications

References 16 publications

The Association of Septic Thrombophlebitis with Septic Pulmonary Embolism in Adults

The Association of Septic Thrombophlebitis with Septic Pulmonary Embolism in Adults

Safety of catheter-directed thrombolysis for deep venous thrombosis in cancer patients

Catheter related venous thrombosis with cooling and warming catheters: two case reports

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