The Association of Septic Thrombophlebitis with Septic Pulmonary Embolism in Adults

Abstract

Background: There have been an increasing number of pediatric reports of septic pulmonary embolism in the setting of septic thrombophlebitis adjacent to a primary infectious source.Methods: Retrospective review at an urban hospital. A total of five adults with a documented primary infectious source, adjacent septic thrombophlebitis and septic pulmonary embolism were identified between 2000 and 2011.Results: The predominant symptoms on presentation were fever and pleuritic chest pain, followed by chills and cough. S. aureus was the pathogen in 4 patients. Only one case had echocardiographic evidence of endocarditis. All patients received IV antibiotics and anticoagulation therapy. No new embolic events or central nervous system complications were noted.Conclusions: The triad of extrapulmonary infection, contiguous septic thrombophlebitis and septic pulmonary embolism is present in adult as well as pediatric populations. The use of systemic anticoagulation with appropriate antibiotics resulted in clinical and radiologic improvement but no significant complications.

Septic Pulmonary Embolism

“…A growth of Staphylococcus was also detected in the blood sample of the patient in this study. [11] Even though antibiotic treatment usually gives a positive treatment response, surgical intervention may be needed depending on the focus of infection. Some of these infections are tricuspid lid replacement, liver apse-specific drainage, and fasciotomy in the case of soft tissue infection.…”

Clinical case report: discitis osteomyelitis complicated by inferior vena cava venous thrombosis and septic pulmonary emboli

“…A few cases in adults have been recently reported where septic thrombophlebitis with contiguous infection resulted in septic pulmonary emboli [22], [23]. However, most of these cases are either due to S aureus or rarely Fusobacterium necrophorum ; both bacteria produce thrombogenic toxins [22], [23]. No case of septic thrombophlebitis associated with viridans streptococcus has been reported.…”

Pulmonary Septic Emboli due to Azygos Vein Septic Thrombosis

“…CT of the chest is the confirmatory imaging procedure of choice [3]. The commonly accepted principles of treatment for septic pulmonary embolism in the setting of septic venous thrombosis include prompt empiric administration of intravenous antibiotics, detecting and removing any potentially infected devices (e.g., intravenous catheters), and considering surgical intervention to remove purulent collections [4].…”

“…However, patients with complications from septic vein embolism who fail to respond to antibiotic therapy alone may require anticoagulant therapy or inferior vena cava filter use. In this case, given her recent surgery, a decision of withholding anticoagulation was made and the patient improved significantly with intravenous antibiotics alone [3]. …”