1/10. Crohn's disease presenting as septic thrombophlebitis of the portal vein (pylephlebitis): case report and review of the literature.Septic thrombophlebitis of the portal vein, or pylephlebitis, is an extremely rare complication of intraabdominal infection, most commonly caused by diverticulitis (1). The following case report describes a patient without previous significant medical history presenting with painless jaundice and presumed malignancy. Workup revealed pylephlebitis due to an ileal abscess secondary to Crohn's disease. The patient was successfully treated with broad spectrum antibiotics and terminal small bowel and right colon resection. To our knowledge, this is the first reported case of Crohn's disease diagnosed after presentation with pylephlebitis.- - - - - - - - - - ranking = 1keywords = thrombophlebitis (Clic here for more details about this article) |
2/10. Medical treatment of a central vein suppurative thrombosis with cerebral metastatic abscesses in a burned child.A 2-year-old girl admitted with third degree burns (35% TBSA) received 7 weeks poly-antibiotic therapy combined with heparin for a severe methicillin-resistant staphylococcus aureus sepsis with multiple metastatic abscesses (lung, skin, brain), from a suppurative thrombophlebitis of the right jugularis interna, extended to the axillary and cava superior veins. Surgical treatment was contraindicated by the local extension. The child was discharged without major neurological sequelae 3 months after admission.- - - - - - - - - - ranking = 0.2keywords = thrombophlebitis (Clic here for more details about this article) |
3/10. Anaerobic infections in surgery: clinical review.Anaerobic bacteria are being recognized with increasing frequency as important micro-organisms in surgical infections. clostridium, Bacteriodes, fusobacterium, and peptostreptococcus are the clinically prominent pathological anaerobes. All are commensals and, consequently, most anaerobic infections are endogenous in origin. In the colon, anaerobes are 1,000 times more prevalent than aerobes. This has important implications regarding the management of gastrointestinal tract operations and the treatment of infections originating from the bowel. Typical anaerobic infections include gas gangrene, brain abscess, oral infections, putrid lung abscesses, intra-abdominal abscesses, and wound infections following gynecologic and bowel surgery, perirectal abscesses, postabortal infections, and septic thrombophlebitis. Infections with anaerobic organisms must be suspected when there is feculent odor and/or gas production following gynecologic or bowel surgery, when there are organisms on gram staining but no growth on aerobic cultures, or when septicemia is associated with repeatedly negative blood cultures. debridement and drainage constitute the main stay of treatment. All anaerobes are sensitive to chloramphenicol and clindamycin and all but Bacteroides fragils are sensitive to penicillin. Identification of anaerobes requires proper specimen sampling, immediate culturing on prereduced media, and careful gram staining of clinical material. The frequency of anaerobic organisms in surgical infections generally is not recognized by many surgeons; their importance needs to be stressed in the future.- - - - - - - - - - ranking = 0.2keywords = thrombophlebitis (Clic here for more details about this article) |
4/10. F-18-fluorodeoxyglucose positron emission tomography leading to a diagnosis of septic thrombophlebitis of the portal vein: description of a case history and review of the literature.Pylephlebitis or septic thrombophlebitis of the portal vein is a serious infectious disorder. early diagnosis is difficult, due to nonspecific symptoms and signs, limitations of diagnostic modalities and the lack of familiarity of physicians with this entity. We report the history of a 73-year-old man with fever of unknown origin (FUO) in whom laboratory tests, blood and urine cultures, chest X-ray, abdominal ultrasound, and indium-111-leucocyte scintigraphy did not reveal the cause of the fever. F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) subsequently pointed to the diagnosis of pylephlebitis, which was confirmed by computed tomography (CT) and percutaneous puncture. We conclude that FDG PET allows detecting inflammatory foci in patients with FUO and offers to make the diagnosis of pylephlebitis at an early stage.- - - - - - - - - - ranking = 1keywords = thrombophlebitis (Clic here for more details about this article) |
5/10. Clinical pharmacokinetics of daptomycin.daptomycin is a new lipopeptide antibiotic for which preliminary pharmacokinetic data in adults have been limited to normal healthy volunteers and patients with renal insufficiency. We report the clinical pharmacokinetics of the first and fifth doses of iv daptomycin 150 mg (2 mg/kg) q24h in a 29-year-old man being treated for a gram-positive cellulitis and thrombophlebitis. Individual pharmacokinetic parameters yielded similar results during doses one and five. The pharmacokinetic profile observed in our patient did not markedly differ from data obtained from healthy volunteers.- - - - - - - - - - ranking = 0.2keywords = thrombophlebitis (Clic here for more details about this article) |
6/10. Suppurative thrombophlebitis due to aeromonas.A patient developed lethal suppurative thrombophlebitis and adjacent soft-tissue infection caused by aeromonas. Potential risk factors included corticosteroid therapy and the use of warm tap water compresses at the site of intravenous catheter-related phlebitis. This case demonstrates the rapidly invasive characteristics of aeromonas and the need for early surgical intervention in suppurative thrombophlebitis.- - - - - - - - - - ranking = 1.2keywords = thrombophlebitis (Clic here for more details about this article) |
7/10. Cutaneous and soft-tissue manifestations of sepsis due to gram-negative enteric bacilli.Four patterns of tissue involvement can be distinguished in sepsis due to gram-negative enteric bacilli. When intense local inflammation predominates, cellulitis or thrombophlebitis results, often with venous or arterial obstruction. bacteria are present in the affected tissues, but not in sufficient numbers to be seen microscopically. When bacterial proliferation is unchecked by an appropriate leukocyte response, ecthyma gangrenosum, erythema multiforme, or diffuse bullous lesions may occur with minimal clinical or histologic signs of inflammation. In symmetric peripheral gangrene associated with disseminated intravascular coagulation, bland fibrinous deposits are seen in small vessels but neither inflammatory cells nor bacteria are present. The fourth kind of lesion is that seen in bacterial endocarditis. In all four patterns a vascular component is prominent clinically and histologically. The pathogenesis of these lesions is multifactorial; in each individual case the interaction between bacterial and host factors probably determines which clinical picture will result. The appearance of symmetric soft tissue lesions of the extremities in the absence of predisposing local conditions suggests the possibility of sepsis due to gram-negative bacilli, especially if other clinical features indicate that sepsis might be present.- - - - - - - - - - ranking = 0.2keywords = thrombophlebitis (Clic here for more details about this article) |
8/10. Complications of space infections of the head and neck.life threatening infections of odontogenic or upper airway origin may extend to potential spaces formed by fascial planes of the lower head and upper cervical area. The incidence of these "space infections" has been greatly reduced by modern antibiotic therapy. However, serious morbidity and even fatalities continue to occur. Two cases of deep neck infection, (one of odontogenic and one tonsillar in origin) with subsequent mediastinitis, empyema, pericarditis and ultimate survival are reported. One case of deep neck infection, (of odontogenic etiology) and suppurative thrombophlebitis of the internal jugular vein with ultimate fatal outcome is also reviewed. review of the literature reveals only one previous case report of a survivor of an odontogenic deep neck infection complicated by mediastinitis, empyema and pericarditis. The anatomy, etiology and treatment of complications of these "space infections" of the head and neck are briefly reviewed.- - - - - - - - - - ranking = 0.2keywords = thrombophlebitis (Clic here for more details about this article) |
9/10. Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management in the modern era.Pylephlebitis usually occurs secondary to infection in the region drained by the portal venous system. We describe a case of pylephlebitis at our institution and examine 18 other cases culled from the literature since 1979, reviewing diagnostic and management issues. A precipitating focus of infection (most commonly diverticulitis) was identified in 13 (68%) of the cases. bacteremia (often polymicrobial) was present in 88% of the patients. The most common blood isolate was bacteroides fragilis. overall mortality was 32%, but most of the patients who died had severe sepsis prior to the initiation of antibiotic therapy. In no case was improvement in a patient's clinical status clearly attributable to the use of heparin, but some beneficial effect of anticoagulation could not be ruled out. This report is the first to examine the published experience with pylephlebitis during the era of antibiotics and modern imaging and is also the first to review critically the role of anticoagulation in the management of this disease.- - - - - - - - - - ranking = 0.8keywords = thrombophlebitis (Clic here for more details about this article) |
10/10. Septic thrombophlebitis of the inferior mesenteric vein associated with diverticulitis CT diagnosis.Septic thrombophlebitis of a mesenteric vein can occur as a rare complication of diverticulitis. We report a case of septic thrombophlebitis of the inferior mesenteric vein diagnosed with computed tomography, in a patient with sigmoid diverticulitis.- - - - - - - - - - ranking = 1.2keywords = thrombophlebitis (Clic here for more details about this article) |
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