Suppurative thrombophlebitis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Pathophysiology
Peripheral Vein
Suppurative thrombophlebitis usually occur in peripheral veins as a result of an intravenous catheter, or dissemination from a surrounding soft tissue infection . Other causes may include intravenous drug use, abrasions, lacerations, hypercoagulable states, and burns.
The high risk of suppurative thrombophlebitis in burn patients is explained by the high skin susceptibility to bacterial infection, use of broad spectrum antibiotics, and impairment of local defense due to loss of skin integrity.[1]
Staphylococcus aureus has been documented as the most common cause of suppurative thrombophlebitis affecting the peripheral veins.[2] Other documented organisms include streptococci, and enterobacteriaceae.[3]
Lemierre's syndrome
Lemierre's syndrome also known as jugular vein suppurative thrombophlebitis,postanginal sepsis, and necrobacillosis.[4] There is extension of the bacterial infection from pharyngitis, tonsillitis, or peri-tonsillar infection, to the carotid sheath vessels that contains the internal jugular vein resulting in inflammation, thrombosis, and infection.[5]
Fusobacterium necrophorum has been documented as the causative pathogen in 80% of Lemierre's syndrome patients.[6] Other pathogens that has been reported include fusobacterium nucleatum, bacteroides species, and streptococcal species.[7]
Vena Cava
Vena cava suppurative thrombophlebitis usually occurs in central venous catheter settings, and the most common pathogens found to be involved are staphylococcus aureus and enterobacteriaceae.[8]
References
- ↑ Pruitt BA, McManus WF, Kim SH, Treat RC (1980). "Diagnosis and treatment of cannula-related intravenous sepsis in burn patients". Ann Surg. 191 (5): 546–54. PMC 1344732. PMID 7369818.
- ↑ Baker CC, Petersen SR, Sheldon GF (1979). "Septic phlebitis: a neglected disease". Am J Surg. 138 (1): 97–103. PMID 464215.
- ↑ Khan EA, Correa AG, Baker CJ (1997). "Suppurative thrombophlebitis in children: a ten-year experience". Pediatr Infect Dis J. 16 (1): 63–7. PMID 9002104.
- ↑ Riordan T, Wilson M (2004). "Lemierre's syndrome: more than a historical curiosa". Postgrad Med J. 80 (944): 328–34. PMC 1743018. PMID 15192164.
- ↑ Sinave CP, Hardy GJ, Fardy PW (1989). "The Lemierre syndrome: suppurative thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection". Medicine (Baltimore). 68 (2): 85–94. PMID 2646510.
- ↑ David H (2009). "A 21-year-old man with fever and abdominal pain after recent peritonsillar abscess drainage". Am J Emerg Med. 27 (4): 515.e3–4. doi:10.1016/j.ajem.2008.07.043. PMID 19555636.
- ↑ Chirinos JA, Lichtstein DM, Garcia J, Tamariz LJ (2002). "The evolution of Lemierre syndrome: report of 2 cases and review of the literature". Medicine (Baltimore). 81 (6): 458–65. PMID 12441902.
- ↑ Kniemeyer HW, Grabitz K, Buhl R, Wüst HJ, Sandmann W (1995). "Surgical treatment of septic deep venous thrombosis". Surgery. 118 (1): 49–53. PMID 7604379.