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PubMed1982

Candidal suppurative peripheral thrombophlebitis.

Transient candidemia is common with prolonged intravenous therapy. Sustained candidemia, however, usually indicates a persistent focus of infection. A complication of intravenous therapy not previously emphasized is persistent candidemia caused by candidal suppurative peripheral thrombophlebitis. We report six cases that appeared during intravenous therapy: the infection was characterized by a thrombosed peripheral vein at an intravenous site with manifestations for candida septicemia with or without disseminated candidiasis. In two patients, the source of the process was occult; the examination showed only a thrombosed noninflamed vein. In all cases, surgical exploration showed the thrombosed veins to be suppurative with positive cultures for Candida. Special stains, moreover, showed Candida in the luminal clot and the vascular wall. In the five surviving patients, cure was achieved by excision of the affected vein. Four received a short course of amphotericin B and 5-fluorocytosine, and one patient received amphotericin B only.

Adult↗
PubMed1998

[Septic thrombophlebitis of the internal jugular vein due to Fusobacterium necrophorum (Lemierre's syndrome): case report and review of literature].

Lemierre's syndrome is an uncommon clinical entity. It is characterized by oropharyngeal infection followed by septic thrombophlebitis of the jugular vein with embolization to the lungs and other organs. It is usually due to Fusobacterium necrophorum. Although Lemierre's syndrome is rare, it is potentially fatal. It is important for clinicians to recognize and treat it appropriately. With prompt recognition, abscess drainage with possible ligation of the internal jugular vein and appropriate antibiotic coverage complete recovery can be achieved in most patients.

Bacteremia↗
PubMed1975

Bilateral deep brachial vein thrombophlebitis due to vibrio fetus.

A patient had bilateral deep brachial vein thrombophlebitis in which Vibrio fetus was recovered from six blood cultures of the six drawn. Fever and phlebitis continued with treatment with intravenous doses of heparin and oxacillin but rapidly improved with treatment change of oxacillin to clindamycin. In vitro antibiotic disk susceptibility testing confirmed resistance to oxacillin and susceptibility to clindamycin. Vibrio fetus infection is associated with the vascular endothelium in this and previously reported cases

Adult↗
PubMed1999

[The influence of the intra-tissue electrical phonophoresis on the hemostasis system in the treatment of acute thrombophlebitis and phlebothrombosis].

In 39 patients with an acute thrombophlebitis and phlebothrombosis there was established the hemostatic potency normalisation, the enzymic fibrinolytic activity of the blood plasm rising, the nonenzymic fibrin/fibrinogen lysis lowering, the plasminogen potential activity restoration and of the fibrinolysis intensity rising, caused by XII factor, under the influence of intratissue electrophonophoresis conduction using nicotinic acid, heparin and novocaine.

Acute Disease↗
PubMed1999

Atypical Sweet's syndrome in a neutropenic patient with acute myeloid leukemia, secondary to a RAEB-T, simulating thrombophlebitis.

We report a rare case of a patient with acute myeloid leukemia following refractory anemia with excess of blasts transformed (RAEB-T) who presented a clinical picture suggestive of thrombophlebitis. The ultrasonographic procedure and the response to corticosteroid treatment suggest that this condition was compatible with an atypical Sweet's syndrome.

Acute Disease↗
PubMed2001

[Treatment policy in thrombophlebitis lesions of the sigmoid sinus and internal jugular vein during intensive use of antibiotics].

152 patients were admitted to the ENT hospital with the diagnosis thrombophlebitis of the sygmoid sinus (62.1% of the total number of the admitted patients with otogenic intracranial complications). The surgery was made early upon the admission. The authors advocate radical removal of the thrombus before, the start of hemorrhage from both sinus parts. In case of the absence of low hemorrhage the intervention on the internal jugular vein was decided on day 1-3 after the basic surgery depending on the clinical course. It is thought that in postoperative period antibiotic therapy should be supplemented with immune preparations made of donor blood, UV radiation of autoblood and hyperbaric oxygenation.

Anti-Bacterial Agents↗
PubMed2002

[Methods of treatment of acute thrombophlebitis of greater saphenous vein].

One-stage combination of thrombectomy on the thigh with compressive sclerotherapy is proposed. This method was used in 66 patients with acute thrombophlebitis of greater saphenous vein (GSV) trunk. It permitted to improve treatment quality, to reduce the scope of subsequent radical operation and to improve its cosmetic result. There were no intraoperative complications. All the patients were discharged in satisfactory state, repeated radical operation for varicose veins of the leg was recommended.

Acute Disease↗
PubMed2002

Lemierre syndrome: usefulness of CT in detection of extensive occult thrombophlebitis.

We report a case of Lemierre syndrome with extensive suppurative thrombophlebitis involving concomitantly the internal jugular, facial and anterior jugular veins. This case illustrates two unusual clinical and imaging features: the lack of characteristic neck symptoms at admission and a negative initial neck US exam. The value of postcontrast CT of the neck and chest for diagnosis of this potentially life-threatening syndrome is illustrated.

Adult↗
PubMed2002

[Diagnosis and therapy of thrombophlebitis with special consideration of low molecular weight heparin].

The clinical diagnosis of superficial thrombophlebitis is characterized by the occurrence of painful and inflamed cords along superficial veins and varices. Duplex sonography is recommended to rule out asymptomatic deep vein thrombosis which may be present in about 20% and to check potential sources of entrance of the thrombotic process into deep veins, like the junctions of great and small saphenous veins. Classic therapy is based on firm compression therapy and walking exercises. Incisions with expression of clots and anti-inflammatory drugs may reduce pain and inflammation. When phlebitis involves also the thigh and especially the proximal part of the great saphenous vein surgical ligation of the junction and local thrombectomy can be considered, preferably on an outpatient basis. Recent data from one randomised controlled trial demonstrate the efficacy of unfractionated heparin in a dose of 12,500 I.U. s. c. twice a day in this indication. According to another randomised controlled trial low molecular weight heparin (LMWH) may reduce the development of thromboembolic complications and also the relatively frequent extension of the thrombi in the superficial veins. Therapeutic doses seem to be more effective than prophylactic doses. While conventional therapy with compression and walking is sufficient for the majority of cases, the additional use of low molecular heparin is recommended in increased thromboembolic risk and when the thigh is involved. In the few studies available treatment time of 6-12 days is reported. More studies with special focus on indication, dosage and duration of therapy with LMWH are needed for the recommendation of clear therapeutic guidelines.

Anticoagulants↗
PubMed1992

[Clinical study of the therapeutic efficacy and tolerance of nimesulide in comparison with a sodium diclofenac in the treatment of acute superficial thrombophlebitis].

The efficacy and tolerability of nimesulide were assessed in a randomized study versus diclofenac sodium in the treatment of 50 patients affected with acute superficial thrombophlebitis. Both drugs, administered in a dose of 1 tablet b.i.d. for 10 days, evidenced a prompt and effective analgesic and anti-inflammatory activity. Particularly, the tolerability of nimesulide was excellent.

Adult↗
PubMed2003

[Changes in cell adhesion molecules under the influence of surgical treatment in patients with acute thrombophlebitis of the subcutaneous veins in the lower extremities].

The content of soluble molecules of intercellular adhesion-1 (sICAM-1) in 60 patients with an acute thrombophlebitis (TP) of the lower extremities subcutaneous veins was studied preoperatively and 7 days after the operation using method of a solid phase immunoenzymatic analysis (IEA). The sICAM-1 level before treatment in men was increased at average by 75.8% (P < 0.001), in women--by 81.5% (P < 0.001) in comparison with control group, after treatment it was lowered somewhat. The gender differences of patients for the average sICAM-1 concentration was not noted. In ascending TP sICAM-1 higher level preoperatively and its normalization on 7th day postoperatively were observed in patients, admitted to in surgical unit and operated 3-5 days after the beginning of disease. In patients, to whom conservative treatment was performed initially (anti-inflammatory and thrombolytic therapy), but its efficacy was minimal, the content of cell adhesion molecules preoperatively and before the treatment did not differ. Positive dynamic of index was revealed after the intervention. The results of investigation trust the important role of cell adhesion in pathogenesis of an acute TP of the lower extremities subcutaneous veins and perspective of application of the sICAM-1 method determination in dynamic of the patients treatment to estimate the surgical efficacy intervention.

Acute Disease↗
PubMed2004

[Acute thrombophlebitis in the territory of saphena magna vein].

Problems of strategy and policy of surgical treatment of acute thrombophlebitis in the territory of saphena magna vein are discussed. Results of urgent radical combined venectomy in 76 patients are presented. A gas technique of subfascial dissection of perforant veins (SEPS) was used in 52 patients for the first time both for diagnosis and adequate treatment of thrombosed perforants. Spread of thrombosis from superficial veins to perforants was revealed in 14.3% patients with C3-C5 class of venous dysfunction (CEAP classification). Isolated and local forms of crus varicothrombophlebitis that must be urgently operated are distinguished. The mean hospital stay was 8.7 bed-days.

Acute Disease↗
PubMed2006

Spontaneous superficial venous thrombophlebitis: does it increase risk for thromboembolism? A historic follow-up study in primary care.

OBJECTIVE: To determine the risk of arterial and venous complications after a spontaneous superficial venous thrombophlebitis (SVTP) in the leg in a general practice population. STUDY DESIGN: Retrospective cohort study (LOE: 2b [CEBM]). Exposure consisted of the diagnosis of SVTP of the lower limbs on an index date. The exposed cohort was compared with an (unexposed) cohort of practice-, age-, and sex-matched controls without SVTP. POPULATION: Patients with spontaneous SVTP in the leg were identified through diagnostic coding in the medical registers of 40,013 patients, enlisted with 5 health centers in Amsterdam, The Netherlands. OUTCOMES: Primary outcomes were deep venous thrombosis (DVT), pulmonary embolism (PE), acute coronary events, or ischemic stroke over a 6-month follow-up period. Odds ratios (OR) were used to quantify the associations between SVTP and outcome events. RESULTS: No statistically significant odds ratios were found for PE, coronary events or stroke. DVT was the only primary outcome to show a significant relationship. DVT occurred in 2.7% of all SVTP patients as compared with 0.2% in the controls (OR=10.2; 95% confidence interval [CI], 2.0-51.6). When controlling for prior history of DVT, the OR decreased to 7.1 and the confidence interval crossed 1.0 (95% CI, 0.9-65.6). DISCUSSION: Spontaneous SVTP in the leg is a risk factor for DVT, but is less predictive in patients with prior DVT. Although effective treatments for the prevention of DVT are available, the absolute risk is too low to advocate prophylaxis in a general practice population. More research on prophylaxis is needed to stratify these patients at risk.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2006

[Phlebothrombosis and thrombophlebitis during the second half of pregnancy and puerperium].

Fhlebothrombosis and thrombophlebitis of the cerebral veins and sinuses develop relatively rare, but they affect young people and have poor prognosis. Pregnancy and puerperium are et risk due to hormonal and homeostatic changes in the organism. This report exhibits the most frequent etiologic factor, early symptoms, clinical manifestation, diagnostic value of the different methods, treatment principals and the factors that determine the outcome of thrombofphlebitis and phlebothrombosis during pregnancy and puerperium. In the acute phase a treatment with direct anticoagulants (intravenous heparin or low molecular mass heparins) and symptomatic treatment with anticonvulsants and drugs against oedema. After the acute phase the treatment continues with oral indirect anticoagulant as long as the severity of the disease requires.

Female↗
PubMed2006

Restricted diffusion in bilateral optic nerves and retinas as an indicator of venous ischemia caused by cavernous sinus thrombophlebitis.

A 44-year-old man developed bilateral blindness following severe periorbital cellulitis and pansinusitis. CT and MR imaging demonstrated bilateral cavernous sinus thrombosis. Diffusion-weighted imaging revealed reduced apparent diffusion coefficient in bilateral optic nerves, suggesting optic nerve ischemia caused by the cavernous sinus thrombophlebitis (CST). Following surgical debridement of pansinusitis, antimicrobial therapy, and anticoagulation, the patient recovered from the infectious episode but sustained permanent bilateral blindness. This case shows that both retinal and optic nerve ischemia can be the cause of blindness after CST. Arguments supporting an arterial-versus-venous origin for the ischemia are discussed.

Adult↗