Extra-cardiac endovascular infections in the critically ill

  • Kerina J. Denny
  • Anand Kumar
  • Jean-Francois Timsit
  • Kevin B. LauplandEmail author
Narrative Review
Part of the following topical collections:
  1. Severe infections in the critically ill


Vascular infections are associated with high complication rates and mortality. While there is an extensive body of literature surrounding cardiac infections including endocarditis, this is less so the case for other endovascular infections. The objective of this narrative review is to summarize the epidemiology, clinical features, and selected management of severe vascular infections exclusive of those involving the heart. Endovascular infections may involve either the arterial or venous vasculature and may arise in native vessels or secondary to implanted devices. Management is complex and requires multi-disciplinary involvement from the outset. Infective arteritis or device-related arterial infection involves removal of the infected tissue or device. In cases where complete excision is not possible, prolonged courses of antimicrobials are required. Serious infections associated with the venous system include septic thrombophlebitis of the internal jugular and other deep veins, and intracranial/venous sinuses. Source control is of paramount importance in these cases with adjunctive antimicrobial therapy. The role of anticoagulation is controversial although recommended in the absence of contraindications. An improved understanding of the management of these infections, and thus improved patient outcomes, requires multi-center, international collaboration.


Arteritis Mycotic aneurysm Thrombophlebitis Endovascular 


Compliance with ethical standards

Conflicts of interest

None of the authors has conflicts of interest to disclose.


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Authors and Affiliations

  1. 1.Department of Intensive CareGold Coast University HospitalGold CoastAustralia
  2. 2.Burns, Trauma and Critical Care Research CentreUniversity of QueenslandHerstonAustralia
  3. 3.Sections of Critical Care Medicine and Infectious Diseases, Health Sciences Centre, Department of MedicineUniversity of ManitobaWinnipegCanada
  4. 4.AP-HP, Bichat Hospital, Medical and Infectious Diseases ICU (MI2)ParisFrance
  5. 5.University of Paris, IAME, INSERMParisFrance
  6. 6.Department of Intensive Care ServicesRoyal Brisbane and Women’s HospitalBrisbaneAustralia
  7. 7.Queensland University of TechnologyBrisbaneAustralia

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