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Septic Thrombophlebitis


Presentation

  • At diagnosis, fever was present in 33 patients (94%), and 33 (94%) had local signs of inflammation. Pus was expressed from the infusion site in 25 patients (71%). All patients had plastic catheters, with 95% present longer than 48 hours.[ncbi.nlm.nih.gov]
  • To our knowledge, this is the first reported case of Crohn's disease diagnosed after presentation with pylephlebitis.[ncbi.nlm.nih.gov]
  • The case study discussed here illustrates the presentation, evaluation, and treatment of Lemierre syndrome.[ncbi.nlm.nih.gov]
  • We report a case of a 57-year-old female patient who presented with fever, abdominal pain, and bacteremia. A CT scan demonstrated sigmoid diverticulitis and air within the inferior mesenteric vein.[ncbi.nlm.nih.gov]
  • Each patient presented with physical findings consistent with thrombophlebitis. Venography, done in two, demonstrated significant acute thrombophlebitis, and another had an infected venous cutdown.[ncbi.nlm.nih.gov]
Chills
  • He also notes fever and chills since last night.[emcurious.com]
  • People with weakened immune systems Infants and children The elderly People with chronic illnesses, such as diabetes, AIDS, cancer, and kidney or liver disease People suffering from a severe burn or physical trauma Common symptoms of sepsis are fever, chills[icdlist.com]
  • The most common symptoms include: fever chills abdominal pain or tenderness flank or back pain a “ropelike” mass in the abdomen nausea vomiting The fever will persist even after taking antibiotics.[healthline.com]
  • The first, most frequent, type of sepsis in children usually occurs without chills, with a high temperature of a constant nature.[minclinic.ru]
  • History A 28-year-old Caucasian male with past medical history significant for intravenous (IV) substance abuse presented to the emergency room complaining of a productive cough, chest pain, fever, chills, sweats, vomiting, and diarrhea for 4 days.[consultant360.com]
Rigor
  • […] ipsilateral jugular venous thrombosis) Venous contamination then acts as a nidus for septicemia and septic embolization Pulmonary septic emboli seen in as high as 90% in some series Patients may initially present with acute pharyngitis Followed by fever, rigors[learningradiology.com]
Painless Jaundice
  • The following case report describes a patient without previous significant medical history presenting with painless jaundice and presumed malignancy. Workup revealed pylephlebitis due to an ileal abscess secondary to Crohn's disease.[ncbi.nlm.nih.gov]
Sputum
  • The following day, the patient’s blood and sputum cultures came back positive for MRSA sensitive to vancomycin and linezolid.[consultant360.com]
Lower Abdominal Pain
Right Upper Quadrant Pain
  • Discussion The most common symptom of GBP is right upper quadrant pain combined with nausea and vomiting.[scipedia.com]
Homans' Sign
  • Thrombophlebitis Symptoms The condition is characterized by the following presenting signs and symptoms: Warmth, tenderness and pain in the area Redness and swelling are noted Positive Homan’s sign: Identification of this problem is by the patient’s foot[byebyedoctor.com]
  • Her calves were free from clubbing, and both Bancroft’s and the Homans signs were negative.[ncbi.nlm.nih.gov]

Workup

  • Workup revealed pylephlebitis due to an ileal abscess secondary to Crohn's disease. The patient was successfully treated with broad spectrum antibiotics and terminal small bowel and right colon resection.[ncbi.nlm.nih.gov]
  • A high index of suspicion is needed to consider this diagnosis in the workup of pharyngitis and should be aggressively treated once identified.[ncbi.nlm.nih.gov]
  • She was initially diagnosed with pharyngitis and inadvertently had blood cultures sent as part of her workup.[scinapse.io]
Mycoplasma Hominis
  • 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.[ncbi.nlm.nih.gov]

Treatment

  • Treatment options are usually limited and effective treatment of infections caused by these pathogens is a considerable challenge for clinicians.[ncbi.nlm.nih.gov]
  • A clinical and microbiologic response occurred when anticoagulation therapy with heparin was added to the treatment regimen.[ncbi.nlm.nih.gov]
  • The patient was successfully treated with conservative treatment consisting of intravenous antibiotics, subcutaneous anticoagulation and percutaneous catheter drainage of liver abscesses. We reported an unnusual case of pylephlebitis in CD.[ncbi.nlm.nih.gov]
  • Empiric antibiotics are the initial treatment of choice followed by thrombolytics or surgical thrombectomy in refractory cases.[ncbi.nlm.nih.gov]
  • A follow-up abdominal computed tomography scan after 3 months of treatment showed that the SMV thrombosis had been resolved.[ncbi.nlm.nih.gov]

Prognosis

  • & symptoms, diagnosis, complications, treatment, prevention, prognosis, and additional useful information HERE .[dovemed.com]
  • Early diagnosis and treatment can improve the prognosis of this disease significantly.[link.springer.com]
  • What are the symptoms, treatment, and prognosis for phlebitis? Pain, swelling, redness, and tenderness are some common symptoms of phlebitis.[medicinenet.com]
  • High-dose parenteral antibiotics Anticoagulation Ligation or resection of the internal jugular vein on occasion Complications Pulmonary septic emboli Empyema Lung abscess Septic arthritis, osteomyelitis or hepatic abscesses through a patent foramen ovale Prognosis[learningradiology.com]
  • Prognosis The prognosis is usually good but the disease process will persist for three or four weeks or more. If it occurs in association with varicose veins there is a high risk of recurrence unless the vein is excised.[patient.info]

Etiology

  • This case represents a unique presentation of septic thrombophlebitis of the coronary sinus in that the infection was localized to the coronary sinus, the etiology was unclear, and the patient recovered uneventfully after surgery.[ncbi.nlm.nih.gov]
  • Abstract Septic thrombophlebitis of the internal jugular vein is a rare condition with diverse etiologies. The significance of the systemic effects of this condition far exceeds its local implications.[ncbi.nlm.nih.gov]
  • Etiology and Pathophysiology Similar to deep venous thrombosis; Virchow triad of vessel trauma, stasis, and hypercoagulability (genetic, iatrogenic, or idiopathic) Varicose veins play a primary role in etiology of lower extremity phlebitis.[unboundmedicine.com]
  • Incidences, pathology, etiology. Surgery 1951; 30: 298–307. PubMed Google Scholar 34. Collins CG. Suppurative pelvic thrombophlebitis: a study of 202 cases in which disease was treated by ligation of the vena cava and ovarian vein.[link.springer.com]
  • To discover the etiology of SPE, echocardiography was performed. It showed tricuspid endocarditis. He was also found, by MRI and CT scan, respectively, to have osteomyelitis in the cervical vertebra and pelvic bone and an abscess in the right thigh.[webview.isho.jp]

Epidemiology

  • Epidemiologic Risks Cannulating the vein, either for medical reason or the use of drugs. As if the two are different.[pusware.com]
  • Incidence and clinical epidemiology of necrobacillosis, including Lemierre’s syndrome, in Denmark 1990–1995.. Eur J Clin Microbiol Infect Dis 17 :, 561– – 565. [CrossRef] [Google Scholar] Huntington M.K., Sewall B.O.. ( 2007 ; ).[jmmcr.microbiologyresearch.org]
  • Infection Control & Hospital Epidemiology ISSN: 0899-823X EISSN: 1559-6834 URL: /core/journals/infection-control-and-hospital-epidemiology[cambridge.org]
  • The epidemiology of peripheral vein infusion thrombophlebitis: a critical review. Am J Med 2002; 113(2): 146–51. PubMed CrossRef Google Scholar 2. Chirinos JA, Lichtstein DM, Garcia J, et al.[link.springer.com]
  • Epidemiology Predominant age Traumatic/IV related has no predominant age/sex.[unboundmedicine.com]
Sex distribution
Age distribution

Pathophysiology

  • There are a multitude of distinct clinical conditions that have been described previously, depending on which venous structure is involved, however the basic pathophysiology remains the same.[emcurious.com]
  • With the primary source of infection most likely being the skin abscess on the upper back, we postulated the most likely pathophysiology that lead to the patient’s condition ( Table ).[consultant360.com]
  • Mondor disease pathophysiology not completely understood Less commonly due to infection (i.e., septic) Staphylococcus aureus, Pseudomonas, Klebsiella, Peptostreptococcus sp. Candida sp.[unboundmedicine.com]
  • Neck radiographs revealed soft tissue gas and computed tomography conf... more Background Lemierre's syndrome presents a classic clinical picture, the pathophysiology of which remains obscure.[scinapse.io]
  • The complications of septic thrombophlebitis include sepsis, septicemia, septic pulmonary emboli, abscess formation, pneumonia Pathophysiology In the absence of a triggering event, neither venous stasis nor abnormal coagulability alone causes clinically[lymphedemapeople.com]

Prevention

  • Septic thrombophlebitis is best prevented by strict asepsis in catheter placement and rotation of infusion sites every 48 hours. Total excision of the infected vein remains the treatment of choice.[ncbi.nlm.nih.gov]
  • Take antibiotics as a preventive measure before and after any surgeries, including a cesarean delivery. Make sure to stretch your legs and move around after your cesarean delivery.[healthline.com]
  • High clinical suspicion and prompt imaging assessment with contrast-enhanced multidetector CT are necessary for correct diagnosis and staging, since early treatment prevents further complications such as systemic embolization.[onlinejets.org]
  • Evaluation and Monitoring 681 Antiretroviral Therapy 689 98 Immune Reconstitution Inflammatory Syndrome 699 99 Differential Diagnosis and Management of Opportunistic 707 100 Prophylaxis of Opportunistic Infections in HIV Infection 721 PART XIII 731 101 Prevention[books.google.com]
  • Doctors try to treat the infection, sustain the vital organs, and prevent a drop in blood pressure. Many patients receive oxygen and intravenous (IV) fluids. Other types of treatment, such as respirators or kidney dialysis, may be necessary.[icdlist.com]

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