THERAPY OF PHLEBOTHROMBOSIS AND THROMBOPHLEBITIS | JAMA Surgery | The JAMA Network Kapralova Methode der Thrombophlebitis
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thrombophlebitis of the median basilic and cephalic veins Ueber eine operative Methode zur Bek\l=a"\mpfung Zur Pathologie und Therapie der Thrombophlebitis.
Updated: Jun 15, Emergency and Kapralova Methode der Thrombophlebitis Department Care. Septic thrombophlebitis is a condition characterized by venous thrombosis, inflammation, and bacteremia.
Many cases present Kapralova Methode der Thrombophlebitis benign, localized venous cords that resolve completely with minimal intervention. Some cases present as severe systemic infections culminating in profound shock that is refractory to aggressive management, including operative intervention and intensive care.
See Presentation and Prognosis. A number of distinct clinical conditions have been identified, depending on the vessel involved, but all thrombophlebitides involve the same basic pathophysiology. Thrombosis and infection within a vein can occur throughout the body and can involve superficial or deep vessels.
See Treatment and Medication. Peripheral septic thrombophlebitis is a common Kapralova Methode der Thrombophlebitis that can develop spontaneously but more often is associated with breaks in the skin. Though most commonly caused by indwelling catheters, septic thrombophlebitis may also result from simple procedures such as venipuncture for phlebotomy and intravenous injection. While infection было Varizen Ellipsoid этом always be considered, catheter-related phlebitis can result from sterile chemical or mechanical irritation.
Septic phlebitis of a superficial vein without frank purulence is known as simple phlebitis. Simple phlebitis is often benign, but when it is progressive, it can cause serious complications, and even death. Suppurative superficial thrombophlebitis is a more serious condition that can lead to sepsis and death, even with appropriate Kapralova Methode der Thrombophlebitis intervention. Septic phlebitis of the deep venous system is a rare, but life-threatening, emergency that may fail to respond to even the most aggressive therapy.
Any vessel can theoretically be involved, but the more common entities are detailed below. Septic thrombophlebitis of the IVC or SVC is primarily the result of central venous catheter placement, with increased incidence in burn patients and those receiving total parenteral nutrition.
The mortality rate of these infections is high, but cases of successful treatment have been reported. Spread of the infection into the parapharyngeal space that houses the carotid sheath leads to local inflammation and thrombosis of the jugular vein. Lemierre syndrome is easily missed and is more common than is generally appreciated. Less commonly, septic emboli may traverse a patent foramen ovale and cause distant metastatic infections such as septic arthritis, osteomyelitis, and hepatic abscesses.
In abdominal infections, such as appendicitis and diverticulitis, infection may spread Kapralova Methode der Thrombophlebitis cause neighboring septic phlebitides.
Thrombophlebitis of the intracranial venous sinuses is a particularly serious Kapralova Methode der Thrombophlebitis and can involve the cavernous sinus, the lateral sinus, or the superior sagittal sinus. Cavernous sinus thrombophlebitis is caused by infection of the medial third of the face known as the "danger zone," ethmoid and sphenoid sinusitis, and, occasionally, oral infections. Mastoiditis and otitis media are rarely associated with septic phlebitis of the lateral sinuses, while thrombophlebitis of the superior sagittal sinus is the rarest and is primarily associated with meningitis.
More than a third of cases of Kapralova Methode der Thrombophlebitis septic thrombophlebitis are fatal. Placement of an intravascular catheter is the main causative factor in the development of phlebitis and septic thrombophlebitis.
Infection can be Krampfadern Cellulite-Massage during the placement of the catheter or bacteria can colonize first the hub and then the lumen of the catheter in Komplikationen den von Krampfadern Beinen they gain access to the intravascular space.
Causative organisms are diverse and include skin and subcutaneous tissue pathogens, enteric bacteria, and flora causing infection in Kapralova Methode der Thrombophlebitis genitourinary tract. The most common infective organism is Staphylococcus aureus, but coagulase-negative staphylococci, enteric gram-negative bacilli, and enterococci are also Kapralova Methode der Thrombophlebitis implicated.
These infections are often polymicrobial. Septic pelvic and ovarian vein thrombophlebitides are often click the following article and typically occur within 3 weeks of delivery. Damage to the intima of pelvic ileofemoral vessels during vaginal or cesarean delivery is thought to contribute to the process of thrombosis.
Hypercoagulability secondary to Kapralova Methode der Thrombophlebitis, as well as the venous stasis common in the peripartum state, also contribute. It may also be caused by other intra-abdominal infections drained by or contiguous with the portal vein.
Bacteroides fragilis is the most common pathogen, but other bacteria, such as Escherichia coliKlebsiella species, and other Bacteroides species, are also found. There has been a case report in which an IVC filter was found to be the nidus of a septic phlebitis. Candida albicans is Kapralova Methode der Thrombophlebitis most common fungal pathogen, but cases have also been attributed to Candida glabrata. In this infection, pathogens translocate through the pharynx or are drained from the pharynx into the lateral pharyngeal space, where they come near to the internal jugular vein.
Inflammation, thrombosis, and infection may then ensue. Infections of the medial third of the face, involving the nose, periorbital regions, tonsils, and него Varizen elastische Binde Олвин palate, have long been recognized risk factors, since these areas drain directly into the cavernous sinus via the facial veins, pterygoid plexus, and ophthalmic veins.
Infections of the sphenoid and ethmoid sinuses have been implicated, with bacteria spreading directly through the lateral wall or via emissary veins. S aureus is by far the most common organism seen in cavernous sinus thrombosis and is responsible for all septic thromboses resulting from facial Kapralova Methode der Thrombophlebitis sphenoid sinusitis.
Streptococci, anaerobes, and occasionally fungi are also seen in cavernous sinus thrombosis. Ina French study found that 9.
Similar rates have been noted for central venous catheters. In general, however, incidences of these deep vein infections appear to be rising, likely owing in part to the increased use of sophisticated diagnostic imaging. In an epidemiologic survey examining the frequency of septic pelvic thrombophlebitis, an overall incidence of deliveries was Kapralova Methode der Thrombophlebitis, with cesarean deliveries having an approximately fold increase in incidence over vaginal deliveries.
Reports from Europe suggested a rate of 0. Vulnerability is also increased in elderly persons, likely secondary to concomitant illnesses and a nonspecific, age-related decline in immunologic function. Garrison et al reported increased risk for the development of major complications from intravenous catheter placement in patients aged 50 years and older, with an odds ratio of 4.
Septic thrombophlebitis is a relatively rare disease that encompasses an array of clinical entities, so data on mortality rates are scarce. Kapralova Methode der Thrombophlebitis to say, it is a serious and dangerous disease, since the infection takes root in the central or peripheral venous system and can Kapralova Methode der Thrombophlebitis progress to sepsis and shock.
Metastatic foci of infection are common, with septic pulmonary emboli, infective endocarditis, septic emboli to the central nervous system, osteomyelitis, septic arthritis, and even arteritis all adding to the morbidity and mortality burden of this disease. Serious complications in survivors include ocular palsies, hemiparesis, blindness, and pituitary insufficiency. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: Update by the Infectious Diseases Society of America.
Leonard JD, Printen KJ. Thrombophlebitis in the elderly. Baker CC, Petersen SR, Sheldon GF. Septic phlebitis: a neglected disease. Pruitt BA Jr, McManus WF, Kim SH, Treat RC. Diagnosis and treatment of cannula-related intravenous sepsis in burn Kapralova Methode der Thrombophlebitis. Strinden WD, Helgerson RB, Maki DG. Candida septic Kapralova Methode der Thrombophlebitis of the great central veins associated with central catheters.
Clinical features and management. Kapralova Methode der Thrombophlebitis A, Widrich WC, Arbeit RD. Central venous septic thrombophlebitis--the role of medical Kapralova Methode der Thrombophlebitis. Sinave CP, Hardy GJ, Fardy PW. The Lemierre syndrome: Kapralova Methode der Thrombophlebitis thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection.
Moore-Gillon J, Lee TH, Eykyn SJ, Phillips I. Necrobacillosis: a forgotten disease. Br Med J Clin Res Ed. Chirinos JA, Lichtstein DM, Garcia J, Tamariz LJ. The evolution of Lemierre syndrome: report of 2 cases and review of the literature. Garcia J, Aboujaoude R, Apuzzio J, Alvarez JR. Septic pelvic thrombophlebitis: diagnosis and management. Infect Dis Obstet Gynecol.
Southwick FS, Richardson EP Jr, Swartz MN. Septic thrombosis of the dural venous sinuses. Khardori N, Yassien M. Biofilms in device-related infections. Arnow PM, Quimosing EM, Beach M.
Consequences of intravascular catheter sepsis. Brown CE, Stettler RW, Twickler D, Cunningham FG. Kapralova Methode der Thrombophlebitis septic pelvic thrombophlebitis: incidence and response Kapralova Methode der Thrombophlebitis heparin therapy. Am J Obstet Gynecol. Plemmons RM, Dooley DP, Longfield RN. Septic thrombophlebitis of the portal vein pylephlebitis : diagnosis and management in the modern era.
Meda MS, Lopez AJ, Guyot A. Candida inferior vena cava filter infection and septic thrombophlebitis. Lee BK, Lopez F, Genovese M, Loutit JS. A year-old man with fever and abdominal pain after recent peritonsillar abscess drainage. Am J Emerg Med. Cannon ML, Antonio BL, McCloskey JJ, Hines MH, Tobin JR, Shetty AK.
Cavernous sinus thrombosis complicating sinusitis. Pediatr Crit Care Med. Watkins LM, Pasternack MS, Banks M, Kousoubris P, Rubin PA. Bilateral cavernous sinus thromboses and intraorbital abscesses secondary to Streptococcus milleri. Richet H, 1 Varizen Grad Foto B, Nitemberg G, Kapralova Methode der Thrombophlebitis al. Prospective multicenter study of vascular-catheter-related complications and risk factors for positive central-catheter cultures in intensive care unit patients.
Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of published prospective studies. Hagelskjaer LH, Prag J, Malczynski J, Kristensen JH. Eur J Clin Microbiol Infect Dis. Riordan T, Wilson M.
Cooley K, Grady S. Garrison RN, Richardson JD, Fry DE. Guidelines for Kapralova Methode der Thrombophlebitis diagnosis, treatment and prevention of postoperative infections. Kagel EM, Rayan GM. Intravenous catheter complications see more the hand and forearm.
Ames JT, Federle MP. Septic thrombophlebitis of the portal venous system: clinical and imaging findings in thirty-three patients. Bogue CO, Leahy TR, Rea DJ, et al.
Idiopathic suppurative pylephlebitis: interventional radiological diagnosis and management. Mori H, Fukuda T, Kapralova Methode der Thrombophlebitis I, Maeda H, Hayashi K. CT diagnosis of catheter-induced septic thrombus of vena cava. J Comput Assist Tomogr. 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. 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. Sashi R, Ito I, Watarai J, Miura K, Horie Y. Picardi M, Pagliuca S, Chiurazzi F, Iula D, Catania M, Rossano F, et al. Source ultrasonographic finding of septic thrombophlebitis is the main indicator of central venous catheter removal Kapralova Methode der Thrombophlebitis reduce infection-related mortality in neutropenic patients with bloodstream Kapralova Methode der Thrombophlebitis. 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. Catheter-related septic thrombophlebitis of the great central veins successfully treated with low-dose streptokinase thrombolysis and antimicrobials.
Josey WE, Staggers SR Jr. Heparin therapy in septic pelvic thrombophlebitis: a study of 46 cases. Cuadrat I, Bielsa S, Pardina M, Porcel JM. Septic thrombophlebitis caused by viridans group Streptococci. Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the click the following article time you visit.
Notable examples are thrombophlebitis in the following see Etiology :. Superior vena cava SVC or inferior vena cava IVC. Internal jugular vein Lemierre syndrome. Causes of peripheral, IVC, and SVC phlebitis include the following:.
Catheter-associated bloodstream infection is a common problem well recognized by the hospital community, and major efforts have been made to combat this problem.
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Surgical Approach to Peritonitis and Abdominal Sepsis. Which Score to Use When Screening for Sepsis on the Wards. Sepsis Linked to Long-Term Risk for Seizures. FDA OKs Rapid Test for Bloodstream Infections, ABX Choice. Bacterial Skin Infections: Can You Make the Diagnosis? According to Infectious Disease Physicians View More. Need a Curbside Consult? Share cases and Kapralova Methode der Thrombophlebitis with Physicians on Medscape consult.
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References, authors & citations for ' Extension of saphenous thrombophlebitis into the femoral vein: Demonstration by color flow compression sonography' on ResearchGate.
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