Suppurative thrombophlebitis overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Suppurative thrombophlebitis is characterized by the co-existence of venous thrombosis along with inflammation and bacteremia.[1] Suppurative thrombophlebitis usually occur in the setting of an intravascular catheter, and suspected in patients with radiographic evidence of thrombosis and persistent bacteremia after 72 hours of appropriate antimicrobial therapy. It is a serious condition that can lead to sepsis and death if not treated properly.
Historical Perspective
Pelvic thrombophlebitis was discovered by the end of the 19th century when von Recklinhausen described an entity in which pelvic infection was characterized by thrombosis of one or both ovarian veins while the remaining pelvis was normal, proposing surgical excision as the therapeutic approach.[2] Sepsis following from a throat infection was first described by Scottmuller in 1918. In 1936, André Lemierre published a series of 20 cases where throat infections were followed by identified anaerobic septicemia, of whom 18 patients died. This disease came to be known as Lemierre syndrome.[3]
Classification
Suppurative thrombophlebitis may be classified into many subtypes according to the vein involved. Subtypes of suppurative thrombophlebitis include peripheral vein, internal jugular vein, vena caval, portal vein, and pelvic vein suppurative thrombophlebitis.
Pathophysiology
Causes
Differentiating Suppurative thrombophlebitis from other Diseases
Peripheral suppurative thrombophlebitis should be differentiated from cellulitis and deep venous thrombosis; while abdominal and pelvic vein suppurative thrombophlebitis must be differentiated from septic abortion, acute appendicitis, cholangitis, and other genitourinary infections. Lemierre disease must be differentiated from peritonsillar abscess, pharyngitis, and soft tissue neck abscess.
Risk Factors
Common risk factors in the development of suppurative thrombophlebitis are the use of intravenous catheters, intravenous drug use, hypercoagulable states, burns, pharyngitis, and tonsillitis.
Epidemiology and Demographics
Natural History, Complications and Prognosis
History and Symptoms
Laboratory Findings
Medical Therapy
Surgery
References
- ↑ Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O'Grady NP; et al. (2009). "Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America". Clin Infect Dis. 49 (1): 1–45. doi:10.1086/599376. PMID 19489710.
- ↑ Garcia J, Aboujaoude R, Apuzzio J, Alvarez JR (2006). "Septic pelvic thrombophlebitis: diagnosis and management". Infect Dis Obstet Gynecol. 2006: 15614. doi:10.1155/IDOG/2006/15614. PMC 1581461. PMID 17485796. Unknown parameter
|http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=ignored (help) - ↑ Lemierre Syndrome. Wikipedia (2015). https://en.wikipedia.org/wiki/Lemierre%27s_syndrome Accessed on October 15, 2015