Central Venous Septic Thrombophlebitis—The Role of Medical Therapy

Verghese, Abraham; Widrich, Warren C.; Arbeit, Robert D.

doi:10.1097/00005792-198511000-00004

Cited by 78 publications

(42 citation statements)

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“…Some reports indicate that surgical thrombectomy should be considered as a therapeutic option (15,16), but others do not (8). Medical therapy alone may be effective in some cases and surgery is not always possible because of the inaccessibility of the central veins (17)(18)(19)(20). However, Caccese et al reported the mortality of those receiving medical therapy to only be 13%, while no deaths were reported among those treated with combined medical and surgical therapy (10); thus, the authors concluded that the decision for combined surgical intervention should be reassessed.…”

Section: Discussionmentioning

confidence: 99%

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Successful Treatment of Recurrent Candidemia due to Candidal Thrombophlebitis Associated with a Central Venous Catheter Using a Combination of Fosfluconazole and Micafungin

Hagiya

Kajioka

2013

Intern. Med.

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We herein report the case of an 85-year-old woman presenting with right internal jugular vein candidal thrombophlebitis associated with central venous catheters (CTCVC). The infecting agent was Candida albicans, which caused recurrent candidemia five times in total. Micafungin (MCFG) alone was ineffective; however, the combination of MCFG with fosfluconazole (F-FLCZ) successfully treated the patient without a need for any anticoagulant or surgical therapies. To the extent of our knowledge, this is the first report of CTCVC being successfully treated with a combination of F-FLCZ and MCFG. These new antifungal agents have better efficacy, tolerability and bioavailability; therefore, they can be useful alternatives to classical combination therapies such as amphotericin-B and 5-fluorocytosine.

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Section: Discussionmentioning

confidence: 99%

“…Heparin has been used in cases of bacterial thrombophlebitis (20), but appears to have no additional beneficial effect (18). Some medical professionals favor anticoagulation only if there is evidence for an extension of the thrombus (21).…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Recurrent Candidemia due to Candidal Thrombophlebitis Associated with a Central Venous Catheter Using a Combination of Fosfluconazole and Micafungin

Hagiya

Kajioka

2013

Intern. Med.

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“…Septic thrombophlebitis of the internal jugular vein has been classically associated with oropharyngeal infections as part of Lemierre syndrome which sometimes is associated with septic emboli to the lungs [16]. Very few cases of septic thrombophlebitis of the superior vena cava, subclavian vein and internal jugular vein due to central venous catheters [3][4][5][6][7] and PICCs [8][9][10] have been reported previously.…”

Section: Discussionmentioning

confidence: 99%

“…Septic thrombophlebitis of the internal jugular vein has been classically associated with oropharyngeal infections [2] and very rarely with CVCs [3][4][5][6][7] and PICCs [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Septic Thrombophlebitis Complicating a Peripherally Inserted Central Catheter

Esmadi¹

2012

J Med Cases

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Peripherally inserted central venous catheters are associated with several complications. Thrombosis, catheter-related infection and phlebitis are well-recognized complications. However, septic thrombophlebitis is very rare. We describe a 44-year-old patient with heart failure who developed extensive septic thrombophlebitis of the right internal jugular, brachicephalic, facial veins and superior vena cava as a complication of prolonged use of a peripherally inserted central venous catheter that was inserted for dobutamine infusion. The catheter was displaced into the internal jugular vein by manipulation of the patient who used it for injection of illegal drugs. Blood cultures grew Citrobacter amalonaticus and Coagulase-negative Staphylococcus with the former growing more often making it the more likely causative agent. The patient was treated successfully with antibiotics and anticoagulation. To our knowledge Citrobacter amalonaticus has not been previously recognized to be associated with septic thrombophlebitis.

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“…Patients with central venous suppurative thrombophlebitis can be successfully treated with prompt catheter removal, intravenous antibiotics and anticoagulation therapy. However, in some cases, a more aggressive approach, such as resection of the affected vein (4,(6)(7)(8)(9) or thrombectomy (10) is needed. We herein report the successful use of pulse-spray treatment (PST) with a pulse-spray catheter for total occlusive jugular venous suppurative thrombophlebitis of methicillin-resistant Staphylococcus aureus (MRSA) that medical therapy failed to treat successfully.…”

Section: Introductionmentioning

confidence: 99%

Pulse-spray Treatment of Total Occlusive Jugular Venous Suppurative Thrombophlebitis

et al. 2013

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A 63-year-old man was diagnosed with jugular venous suppurative thrombophlebitis after undergoing strangulation ileus surgery. His condition was not stabilized by therapy with antibiotics, heparin or other supportive treatments. Pulse-spray treatment (PST) was administered, following which, the patient was afebrile without symptoms and the laboratory data improved. There were no complications such as sustained sepsis, septic embolisms or pulmonary embolisms. This is a unique case report of the use of a pulse-spray catheter in the treatment of total occlusive jugular venous suppurative thrombophlebitis following the failure of medical therapy.

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Central Venous Septic Thrombophlebitis—The Role of Medical Therapy

Cited by 78 publications

References 0 publications

Successful Treatment of Recurrent Candidemia due to Candidal Thrombophlebitis Associated with a Central Venous Catheter Using a Combination of Fosfluconazole and Micafungin

Successful Treatment of Recurrent Candidemia due to Candidal Thrombophlebitis Associated with a Central Venous Catheter Using a Combination of Fosfluconazole and Micafungin

Septic Thrombophlebitis Complicating a Peripherally Inserted Central Catheter

Pulse-spray Treatment of Total Occlusive Jugular Venous Suppurative Thrombophlebitis

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