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PubMed2006

Excision of internal jugular vein for catheter-related thrombophlebitis.

This report describes a case of internal jugular vein (IJV) thrombophlebitis refractory to intravenous (IV) antibiotics and anticoagulation managed with ligation and excision of the vein. Our patient was immunosuppressed for a transplanted organ and developed a catheter-related infection following major pelvic surgery. His symptoms worsened, and failure of medical management prompted operative intervention. Excision of the inflamed, thrombosed vein led to complete resolution of his symptoms.

Catheterization, Central Venous↗
PubMed1983

Antithrombin III Toyama: a hereditary abnormal antithrombin III of a patient with recurrent thrombophlebitis.

A familial abnormal antithrombin III (AT-III) is reported. The characteristic of the abnormality in this family is low heparin cofactor activity with normal progressive antithrombin activity and normal or rather increased level of AT-III antigen. The patient is a 23-year-old female who had suffered from recurrent thrombophlebitis involving her lower extremities. Her plasma AT-III antigen concentration was 54 mg/dl and progressive antithrombin and factor Xa inhibitory activities were of normal level. However, the heparin cofactor activity of her plasma was as low as 26% of normal control. On crossed immunoelectrophoresis (CIE) containing heparin in the first dimension agarose, patient's AT-III showed no increase in electrophoretic mobility compared to that in the absence of heparin, suggesting that the patient's AT-III has no affinity for heparin. From CIE pattern in the presence of heparin, the patient was found to be a homozygote, and parents and one of her younger sisters were heterozygotes. Thus, the mode of inheritance is proposed to be autosomal dominant.

Adult↗
PubMed1990

Superficial thrombophlebitis. I. Primary hypercoagulable states.

This review concentrates on those disorders in which superficial thrombophlebitis can be a significant or presenting clinical sign. Primary hypercoagulable states are those conditions associated with an increased risk of thrombosis caused by a specific measurable defect in the proteins of coagulation and/or fibrinolytic systems. These disorders are frequently inherited and include deficiencies of antithrombin III, heparin cofactor 2, protein C, protein S, abnormal fibrinolytic activity, dysfibrinogenemia, and Hageman trait. Patients with a lupus anticoagulant and anticardiolipin antibody syndrome with thrombotic episodes are also considered to have a primary hypercoagulable state. The physiology, pathophysiology, clinical characteristics, and treatment of primary hypercoagulable states are reviewed.

Blood Coagulation↗
PubMedDate not supplied

Mycoplasma hominis septic thrombophlebitis in a patient with multiple trauma: a case report and literature review.

Mycoplasma hominis was recovered from the site of a septic thrombophlebitis on the left cephalic veins of a patient with pelvic and other multiple trauma. The organisms were initially isolated from routine cultures in conventional blood agar media incubated anaerobically. The absence of other demonstrable pathogens and the patient's serologic response to the isolate support the role of the organism as the cause of this previously unreported mycoplasmal infection. M. hominis should be considered a possible cause of sepsis in selected cases of infections following pelvic trauma or manipulations of the genitourinary tract.

Adult↗
PubMedDate not supplied

Thrombophlebitis of the hepatic veins: complication of a Klebsiella liver abscess.

Among the various causative agents of an abscess of the liver, Klebsiella is a frequent and well-known cause, and its imaging findings have been described in the past decades. We report two cases of this type of abscess, which were of interest because of associated findings indicating a subhepatic thrombophlebitis of the liver, a process which could have explained the development of a concomitant pulmonary infectious process.

Adult↗
PubMed2001

[Lemierre's syndrome: septic thrombophlebitis of the internal jugular vein secondary to acute amygdalitis].

Lemierre's syndrome is an uncommon clinical entity. It consists of an acute oropharyngeal infection, with secondary septic thrombophlebitis of the internal jugular vein frequently complicated with multiple metastatic infections. It is generally caused by anaerobic Gram-negative organisms. Although it is rarely reported in the antibiotic era, this disease must be taken into account because it is a potentially life-threatening infection requiring a specific and early treatment. We report a case of Lemierre's syndrome managed in our hospital.

Acute Disease↗
PubMed2003

[Thrombophlebitis of the right ovarian vein with thrombosis of the inferior vena cava].

A 39-years-old woman was admitted with pelvic pain and fever occurring one month after a caesarean. An echography-doppler and an abdominal tomodensitometry were performed. Thrombophlebitis of the right ovarian vein was diagnosed with extension of a floating thrombus into the inferior vena cava. We decided to perform a surgical thrombectomy due to a pulmonary embolism which occurred while the patient was under heparin and antibiotic treatment. A temporary percutaneous caval filter was successfully used in the peri-operative period, preventing a second embolism. This observation focuses on a rare pathology occurring in young women and emphasises the safe use and removal of a temporary percutaneous caval filter in the peri-operative period.

Adult↗
PubMed1998

Superficial suppurative thrombophlebitis in children, caused by anaerobic bacteria.

OBJECTIVE: The purpose of this study was to present the microbiology and clinical features of six children with superficial suppurative thrombophlebitis (SST) caused by anaerobic bacteria. METHODS: A retrospective review of microbiological and clinical data was undertaken. RESULTS: Anaerobic bacteria alone were recovered in four instances, and they were mixed with facultative bacteria in two. There were 12 bacterial isolates (10 anaerobic and 2 facultatives). The bacteria were Peptostreptococcus species (four isolates), Prevotella species (three), and one isolate each of Fusobacterium nucleatum, Propionibacterium acnes, Staphylococcus aureus, and Staphylococcus epidermidis. SST at an intravenous infusion site developed in all but one patient. One patient sustained trauma to the leg, and cellulitis developed. Anaerobes of oral origin (Prevotella and Fusobacterium species) were recovered in scalp vein SST, and of gastrointestinal origin (Bacteroides fragilis) in a lower extremity SST. CONCLUSION: This study highlights the potential importance of anaerobic bacteria in children with SST.

Anti-Bacterial Agents↗
PubMed2000

[Effect of topical and oral diclofenac on superficial thrombophlebitis caused by intravenous infusion].

BACKGROUND: Until present time, suggested treatments for superficial thrombophlebitis induced by intravenous infusion (TFSI), are of uncertain effectiveness and most of them or empirical and not fully researched. The aim of this report is to study the effectiveness and safety of the topical and oral administration of diclofenac in the treatment of TFSI. PATIENTS AND METHODS: In this prospective study 120 patients both female and male were included. All of them developed TFSI during hospitalization and at the same time they were assigned at random to one of the following groups: G-control (n = 40), without treatment; G-topical (n = 40), diclofenac emulsion gel used in a topical way on the concerned area every 8 hours during 48 hours; G-oral (n = 40), diclofenac 75 mg p.o. every 12 hours during 48 hours. The measurements were done at the moment of diagnosis of TFSI (T0) and 48 hours later (T2). Registries of intensity of TFSI were done by quantifying flushing, tumor, heatness and pain. These data were compared considering the averages of differences registered in T2 with respect to T0. A decrease of intensity of TFSI > or = 30% was considered a positive answer to this treatment. The quantitative variables were studied with ANOVA, Kruskal-Wallis test or general linear model and the qualitative with the chi 2 test with Yates correction. The level of significance used was alpha = 0.05. RESULTS: The averages of differences in the intensity of TFSI that were registered in the groups G-control, G-topical and G-oral in T2 compared to T0 are: -0.12 (4.89), -5.70 (3.13), -4.82 (3.14) (p = 0.000). The favorable answers in G-control, G-topical and G-oral were: 20, 60 and 60%, respectively (p = 0.0001). The adverse reactions in G-topical and G-oral were: headache 9-5 (p = 0.2), epigastric pain 4-17 (p = 0.0009), nausea 6-16 (p = 0.01) and local pruritus 5-2 (p = 0.2). The treatment did not report serious adverse reactions in either of the groups. CONCLUSION: The topical treatment of diclofenac can be recommended as an alternative simple, effective and safe therapy for patients who develop TFSI.

Administration, Oral↗
PubMed1991

Magnetic resonance imaging for calf deep venous thrombophlebitis.

STUDY OBJECTIVE: To compare magnetic resonance imaging (MRI) of the calf with venography for patients with suspected calf deep venous thrombophlebitis (DVT). DESIGN: Ten consecutive adult patients with suspected calf DVT received venography and, within 48 hours, MRI scans. The tests were reviewed blindly by two radiologists, and results of the tests were compared. SETTING: The emergency department of a large teaching hospital with an annual census of 60,000 patients. MAIN RESULTS: All patients with negative venograms had no suggestion of DVT on MRI scan. Two of these patients had other significant demonstrable abnormalities. Four of the five patients with positive venograms had positive calf MRI scans. One patient with a venogram that was difficult to interpret had no DVT on MRI. A thigh DVT was seen on his venogram and was suggested by MRI findings. CONCLUSION: MRI may replace ascending venography as the standard for diagnosis of calf DVT.

Emergency Medicine↗
PubMed2002

[Ovarian vein thrombophlebitis and post-partum fever].

INTRODUCTION: Ovarian vein thrombophlebitis (OVT) is a rare but potentially threatening complication of the postpartum period. Diagnosing it may be of some difficulty especially in case of symptoms mimicking appendicitis or pyelonephritis. EXEGESIS: We report 2 patients with postpartum right OVT. The clinical presentation included high grade fever, and pain, lumbar in one case, of the right flank in the other. Pulmonary embolism complicated both cases. CONCLUSION: Diagnostic and therapeutic management of OVT was transformed by progresses in medical imaging during the 1980's. However, optimal duration of anticoagulant treatment and secondary prevention indications have to be determined.

Adult↗
PubMed2000

Cannula related suppurative thrombophlebitis in the burned patient.

Suppurative thrombophlebitis is a well recognised and potentially fatal complication of intravenous cannulation in burns patients. We report a case of an Afro-Caribbean patient with noninsulin-dependent diabetes who developed signs of systemic sepsis two weeks after a 14% total body surface area flame burn. Despite an initial paucity of clinical signs at the cannulation site, exploratory venotomy revealed frank suppuration within the long saphenous vein from the ankle to the groin. This was treated successfully by total excision of the vein and its tributaries and delayed wound closure. Following this, a retrospective analysis of the measured clinical parameters and blood tests revealed no obvious, missed pointers to the impending sepsis other than a dramatic increase in the overall daily insulin requirement. This had doubled over a 48-h period, preceding the clinical diagnosis by three days. The relevant literature and guidelines for management are reviewed.

Adult↗
PubMed1997

Thrombophlebitis of the inferior vena cava involving the retroperitoneum with Crohn's disease: MR demonstration.

We present a case of thrombophlebitis of the inferior vena cava (IVC) with Crohn's disease after intestinal perforation and prolonged indwelling of a catheter in the IVC. Magnetic resonance imaging demonstrated abnormal thickening and enhancement of the IVC wall. In addition, IVC thrombus formation was shown. The abnormal enhancement extended from the wall in the pericaval tissue and into the retroperitoneum, and regressed as the Crohn's disease subsided.

Adult↗
PubMed1997

Traumatic thrombophlebitis of the superficial dorsal vein of the penis: an occupational hazard.

Several cases of thrombophlebitis of the superficial dorsal vein of the penis (TSDVP) have been reported in the literature. Etiologies may include any of the following: trauma associated with vigorous sexual intercourse; penile strangulation caused by a multitude of entities; penile injection; infection; neoplasm; or surgery. We report a rare case of traumatic TSDVP in a cab driver following repeated injury to the penis by a coin-filled pouch. We review the etiologies, mechanism, and treatment of traumatic TSDVP, and attempt to identify men who may be at similar occupational risk.

Adult↗
PubMed1998

Occult deep venous thrombosis complicating superficial thrombophlebitis.

PURPOSE: To determine whether superficial thrombophlebitis (STP) can extend into the deep venous system (DVS) and whether this may result in pulmonary embolization. METHODS: All venous duplex ultrasound examinations performed in our vascular laboratory to rule out deep venous thrombosis from June 1, 1994, to June 24, 1996, were reviewed. RESULTS: Of 8313 limbs studied by duplex scanning in 6148 patients, 1756 limbs (21.1%) had a positive result for deep venous thrombosis. STP was demonstrated in 232 limbs (213 patients), of which 20 (8.6%) extended into the DVS. Fourteen (70%) were noted on the initial scan, and six (30%) were detected on serial follow-up scans. Eighteen (90%) originated in the proximal greater saphenous vein and extended across the saphenofemoral junction into the common femoral vein. Nine demonstrated "free-floating" thrombus with a "tongue" extending into the common femoral vein while still attached proximally to the greater saphenous vein. Extension of thrombus from the lesser saphenous vein into the popliteal vein was noted in two cases (10%). One pulmonary embolization was directly observed to occur in real time during scanning. No pulmonary embolization was seen when STP did not involve the DVS. CONCLUSIONS: STP can extend into the DVS. In this series STP of the proximal greater saphenous vein extended into the common femoral vein in 8.6% of the cases, of which 10% embolized to the lungs. When the DVS is involved, standard deep venous thrombosis treatment (heparin, warfarin, bed rest) should be instituted. We recommend duplex imaging for STP involving the greater saphenous vein in the thigh to rule out occult deep venous thrombosis. STP is not always benign and self-limiting as previously described.

Femoral Vein↗