Septic Thrombophlebitis Questions & Answers

1. [Guideline] Mermel LA, Allon M, Bouza E, et al. 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. 2009 Jul 1. 49(1):1-45. [QxMD MEDLINE Link].

2. Valerio L, Riva N. Head, Neck, and Abdominopelvic Septic Thrombophlebitis: Current Evidence and Challenges in Diagnosis and Treatment. Hamostaseologie. 2020 Aug. 40 (3):301-310. [QxMD MEDLINE Link].

3. Leonard JD, Printen KJ. Thrombophlebitis in the elderly. Am Surg. 1980 Aug. 46(8):441-3. [QxMD MEDLINE Link].

4. Baker CC, Petersen SR, Sheldon GF. Septic phlebitis: a neglected disease. Am J Surg. 1979 Jul. 138(1):97-103. [QxMD MEDLINE Link].

5. Pruitt BA Jr, McManus WF, Kim SH, Treat RC. Diagnosis and treatment of cannula-related intravenous sepsis in burn patients. Ann Surg. 1980 May. 191(5):546-54. [QxMD MEDLINE Link]. [Full Text].

6. Strinden WD, Helgerson RB, Maki DG. Candida septic thrombosis of the great central veins associated with central catheters. Clinical features and management. Ann Surg. 1985 Nov. 202(5):653-8. [QxMD MEDLINE Link]. [Full Text].

7. Verghese A, Widrich WC, Arbeit RD. Central venous septic thrombophlebitis--the role of medical therapy. Medicine (Baltimore). 1985 Nov. 64(6):394-400. [QxMD MEDLINE Link].

8. Sinave CP, Hardy GJ, Fardy PW. The Lemierre syndrome: suppurative thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection. Medicine (Baltimore). 1989 Mar. 68(2):85-94. [QxMD MEDLINE Link].

9. Moore-Gillon J, Lee TH, Eykyn SJ, Phillips I. Necrobacillosis: a forgotten disease. Br Med J (Clin Res Ed). 1984 May 19. 288(6429):1526-7. [QxMD MEDLINE Link]. [Full Text].

10. Chirinos JA, Lichtstein DM, Garcia J, Tamariz LJ. The evolution of Lemierre syndrome: report of 2 cases and review of the literature. Medicine (Baltimore). 2002 Nov. 81(6):458-65. [QxMD MEDLINE Link].

11. Garcia J, Aboujaoude R, Apuzzio J, Alvarez JR. Septic pelvic thrombophlebitis: diagnosis and management. Infect Dis Obstet Gynecol. 2006. 2006:15614. [QxMD MEDLINE Link]. [Full Text].

12. Southwick FS, Richardson EP Jr, Swartz MN. Septic thrombosis of the dural venous sinuses. Medicine (Baltimore). 1986 Mar. 65(2):82-106. [QxMD MEDLINE Link].

13. Khardori N, Yassien M. Biofilms in device-related infections. J Ind Microbiol. 1995 Sep. 15(3):141-7. [QxMD MEDLINE Link].

14. Arnow PM, Quimosing EM, Beach M. Consequences of intravascular catheter sepsis. Clin Infect Dis. 1993 Jun. 16(6):778-84. [QxMD MEDLINE Link].

15. Brown CE, Stettler RW, Twickler D, Cunningham FG. Puerperal septic pelvic thrombophlebitis: incidence and response to heparin therapy. Am J Obstet Gynecol. 1999 Jul. 181(1):143-8. [QxMD MEDLINE Link].

16. Plemmons RM, Dooley DP, Longfield RN. Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management in the modern era. Clin Infect Dis. 1995 Nov. 21(5):1114-20. [QxMD MEDLINE Link].

17. Meda MS, Lopez AJ, Guyot A. Candida inferior vena cava filter infection and septic thrombophlebitis. Br J Radiol. 2007 Feb. 80(950):e48-9. [QxMD MEDLINE Link].

18. Lee BK, Lopez F, Genovese M, Loutit JS. Lemierre's syndrome. South Med J. 1997 Jun. 90(6):640-3. [QxMD MEDLINE Link].

19. David H. A 21-year-old man with fever and abdominal pain after recent peritonsillar abscess drainage. Am J Emerg Med. 2009 May. 27(4):515.e3-4. [QxMD MEDLINE Link].

20. Cannon ML, Antonio BL, McCloskey JJ, Hines MH, Tobin JR, Shetty AK. Cavernous sinus thrombosis complicating sinusitis. Pediatr Crit Care Med. 2004 Jan. 5(1):86-8. [QxMD MEDLINE Link].

21. Watkins LM, Pasternack MS, Banks M, Kousoubris P, Rubin PA. Bilateral cavernous sinus thromboses and intraorbital abscesses secondary to Streptococcus milleri. Ophthalmology. 2003 Mar. 110(3):569-74. [QxMD MEDLINE Link].

22. Richet H, Hubert B, Nitemberg G, et al. Prospective multicenter study of vascular-catheter-related complications and risk factors for positive central-catheter cultures in intensive care unit patients. J Clin Microbiol. 1990 Nov. 28(11):2520-5. [QxMD MEDLINE Link]. [Full Text].

23. Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc. 2006 Sep. 81(9):1159-71. [QxMD MEDLINE Link].

24. Hagelskjaer LH, Prag J, Malczynski J, Kristensen JH. Incidence and clinical epidemiology of necrobacillosis, including Lemierre's syndrome, in Denmark 1990-1995. Eur J Clin Microbiol Infect Dis. 1998 Aug. 17(8):561-5. [QxMD MEDLINE Link].

25. Riordan T, Wilson M. Lemierre's syndrome: more than a historical curiosa. Postgrad Med J. 2004 Jun. 80(944):328-34. [QxMD MEDLINE Link]. [Full Text].

26. Cooley K, Grady S. Minimizing catheter-related bloodstream infections: one unit's approach. Adv Neonatal Care. 2009 Oct. 9(5):209-26; quiz 227-8. [QxMD MEDLINE Link].

27. Garrison RN, Richardson JD, Fry DE. Catheter-associated septic thrombophlebitis. South Med J. 1982 Aug. 75(8):917-9. [QxMD MEDLINE Link].

28. Gore MR. Lemierre Syndrome: A Meta-analysis. Int Arch Otorhinolaryngol. 2020 Jul. 24 (3):e379-e385. [QxMD MEDLINE Link].

29. [Guideline] Larsen JW, Hager WD, Livengood CH, Hoyme U. Guidelines for the diagnosis, treatment and prevention of postoperative infections. Infect Dis Obstet Gynecol. 2003. 11(1):65-70. [QxMD MEDLINE Link]. [Full Text].

30. Kagel EM, Rayan GM. Intravenous catheter complications in the hand and forearm. J Trauma. 2004 Jan. 56(1):123-7. [QxMD MEDLINE Link].

31. Ames JT, Federle MP. Septic thrombophlebitis of the portal venous system: clinical and imaging findings in thirty-three patients. Dig Dis Sci. 2011 Jul. 56(7):2179-84. [QxMD MEDLINE Link].

32. Bogue CO, Leahy TR, Rea DJ, et al. Idiopathic suppurative pylephlebitis: interventional radiological diagnosis and management. Cardiovasc Intervent Radiol. 2009 Nov. 32(6):1304-7. [QxMD MEDLINE Link].

33. Mori H, Fukuda T, Isomoto I, Maeda H, Hayashi K. CT diagnosis of catheter-induced septic thrombus of vena cava. J Comput Assist Tomogr. 1990 Mar-Apr. 14(2):236-8. [QxMD MEDLINE Link].

34. Linn J, Ertl-Wagner B, Seelos KC, et al. Diagnostic value of multidetector-row CT angiography in the evaluation of thrombosis of the cerebral venous sinuses. AJNR Am J Neuroradiol. 2007 May. 28(5):946-52. [QxMD MEDLINE Link].

35. Twickler DM, Setiawan AT, Evans RS, et al. Imaging of puerperal septic thrombophlebitis: prospective comparison of MR imaging, CT, and sonography. AJR Am J Roentgenol. 1997 Oct. 169(4):1039-43. [QxMD MEDLINE Link].

36. Sashi R, Ito I, Watarai J, Miura K, Horie Y. Thrombophlebitis of the inferior vena cava involving the retroperitoneum with Crohn's disease: MR demonstration. Magn Reson Imaging. 1997. 15(9):1099-101. [QxMD MEDLINE Link].

37. Picardi M, Pagliuca S, Chiurazzi F, Iula D, Catania M, Rossano F, et al. Early ultrasonographic finding of septic thrombophlebitis is the main indicator of central venous catheter removal to reduce infection-related mortality in neutropenic patients with bloodstream infection. Ann Oncol. 2012 Mar 2. [QxMD MEDLINE Link].

38. Mertz D, Khanlari B, Viktorin N, Battegay M, Fluckiger U. Less than 28 days of intravenous antibiotic treatment is sufficient for suppurative thrombophlebitis in injection drug users. Clin Infect Dis. 2008 Mar 1. 46(5):741-4. [QxMD MEDLINE Link].

39. Cox ER, Amoroso A, Gilliam BL. Pannus attack: septic thrombophlebitis. Am J Med. 2012 Dec. 125 (12):1175-7. [QxMD MEDLINE Link].

40. Volkow P, Cornejo-Juárez P, Arizpe-Bravo AB, García-Méndez J, Baltazares-Lipp E, Pérez-Padilla R. Catheter-related septic thrombophlebitis of the great central veins successfully treated with low-dose streptokinase thrombolysis and antimicrobials. Thromb J. 2005 Aug 22. 3:11. [QxMD MEDLINE Link].

41. Golpe R, Marín B, Alonso M. Lemierre's syndrome (necrobacillosis). Postgrad Med J. 1999 Mar. 75(881):141-4. [QxMD MEDLINE Link]. [Full Text].

42. Ashraf M, Laurich D, Huntington M. Septic thrombophlebitis of the internal jugular and subclavian veins treated with percutaneous mechanical thrombolysis. JMM Case Rep. 2015. 1. [Full Text].

43. Josey WE, Staggers SR Jr. Heparin therapy in septic pelvic thrombophlebitis: a study of 46 cases. Am J Obstet Gynecol. 1974 Sep 15. 120(2):228-33. [QxMD MEDLINE Link].

JE Robyn Hanna, MD, MS Resident Physician, Department of Emergency Medicine, University of Kentucky College of Medicine

JE Robyn Hanna, MD, MS is a member of the following medical societies: American Academy of Family Physicians, American Medical Association, American Medical Women's Association, Emergency Medicine Residents' Association

Disclosure: Nothing to disclose.

Christopher I Doty, MD, MAAEM, FAAEM, FACEP Tenured Professor of Emergency Medicine, University of Kentucky College of Medicine; Vice Chair of Education, Department of Emergency Medicine, University of Kentucky Chandler Medical Center

Christopher I Doty, MD, MAAEM, FAAEM, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, Council of Residency Directors in Emergency Medicine

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Jeter (Jay) Pritchard Taylor, III, MD Assistant Professor, Department of Surgery, University of South Carolina School of Medicine; Attending Physician / Clinical Instructor, Compliance Officer, Department of Emergency Medicine, Prisma Health Richland Hospital

Jeter (Jay) Pritchard Taylor, III, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Columbia Medical Society, Society for Academic Emergency Medicine, South Carolina College of Emergency Physicians, South Carolina Medical Association

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Employed contractor - Chief Editor for Medscape.

Juliet D Caldwell, MD Assistant Professor, Department of Emergency Medicine, Weill Cornell Medical College; Attending Physician, Department of Emergency Medicine, New York Presbyterian Hospital, Weill-Cornell Medical Center; Attending Physician, Department of Emergency Medicine, Long Island College Hospital

Juliet D Caldwell, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Nicholas J Connors, MD Assistant Professor, Director, Section of Medical Toxicology, Emergency Medicine Residency Core Faculty, Department of Medicine, Division of Emergency Medicine, Medical University of South Carolina College of Medicine

Nicholas J Connors, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Emergency Physicians, American College of Medical Toxicology

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Craig F Feied, MD, FACEP, FAAEM, FACPh Professor of Emergency Medicine, Georgetown University School of Medicine; General Manager, Microsoft Enterprise Health Solutions Group

Craig F Feied, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Phlebology, American College of Physicians, American Medical Association, American Medical Informatics Association, American Venous Forum, Medical Society of the District of Columbia, Society for Academic Emergency Medicine, and Undersea and Hyperbaric Medical Society

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Jonathan A Handler, MD HSG Chief Deployment Architect, Microsoft Corporation, Adjunct Associate Professor, Department of Emergency Medicine, Northwestern University, Feinberg School of Medine

Jonathan A Handler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Richard S Krause, MD Senior Clinical Faculty/Clinical Assistant Professor, Department of Emergency Medicine, University of Buffalo State University of New York School of Medicine and Biomedical Sciences

Richard S Krause, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Eddy S Lang, MDCM, CCFP(EM), CSPQ Associate Professor, Senior Researcher, Division of Emergency Medicine, Department of Family Medicine, University of Calgary Faculty of Medicine; Assistant Professor, Department of Family Medicine, McGill University Faculty of Medicine, Canada

Eddy S Lang, MDCM, CCFP(EM), CSPQ is a member of the following medical societies: American College of Emergency Physicians, Canadian Association of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

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Christian Theodosis, MD, MPH Resident Physician, Section of Emergency Medicine, Yale School of Medicine

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