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Septic Thrombophlebitis

Diagnosis and Management

Abstract

Septic thrombophlebitis, as a result of invasion from adjacent nonvascular infections, includes conditions such as Lemierre syndrome (internal jugular vein septic thrombophlebitis), pylephlebitis (portal vein septic thrombophlebitis), and septic thrombophlebitis of the dural sinuses and the pelvic veins. All of these conditions are associated with a very high mortality if untreated. Appropriate antibacterial therapy dramatically improves the outcome of these infections and results in a low mortality rate, with the notable exception of septic thrombophlebitis of the durai sinuses. The endovascular nature of these infections results in secondary metastatic disease, including pneumonia, endocarditis, and arthritis due to septic embolization and/or hematogenous bacterial spread. The appropriate diagnosis and management of these infections depends on a high degree of clinical suspicion, the use of imaging studies, and early initiation of empiric antibacterial therapy. In this article, we review the diagnosis and management of septic thrombophlebitis, focusing on Lemierre syndrome, pylephlebitis, and septic thrombophlebitis of the pelvic veins.

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Acknowledgments

No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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Correspondence to Julio A. Chirinos.

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Chirinos, J.A., Garcia, J., Alcaide, M.L. et al. Septic Thrombophlebitis. Am J Cardiovasc Drugs 6, 9–14 (2006). https://doi.org/10.2165/00129784-200606010-00002

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Keywords

  • Septic Arthritis
  • Antibacterial Therapy
  • Dural Sinus
  • Ovarian Vein
  • Splenic Abscess