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Suppurative thrombophlebitis: correlation between pathogen and underlying disease
Abstract:
We identified 29 episodes of suppurative thrombophlebitis in 27 patients admitted to a large general hospital between May 1980 and May 1984. In 25 patients, the intravenous cannulae had been in place for more than 3 days. Streptococcus faecalis, Pseudomonas aeruginosa or one of the Enterobacteriaceae were implicated in 14 patients. All these patients had recently undergone abdominal surgery or had a major intra-abdominal inflammatory process at the time they developed thrombophlebitis. The remaining 13 patients were infected with Staphylococcus aureus, other gram-positive cocci or Candida species. Only two of these had an active abdominal process at the time of their infection (chi 2 = 16.08, P less than 0.001). There is an apparent association between phlebitis caused by enteric organisms and active intra-abdominal pathology. There were two deaths related to delayed or deferred surgery. Suppurative thrombophlebitis is a lethal, preventable nosocomial infection that requires urgent surgical intervention.
Insights
Suppurative thrombophlebitis, a serious hospital-acquired infection, is linked to prolonged intravenous cannula use. Prompt surgical intervention is crucial for patient outcomes.
Area of Science:
- Infectious Diseases
- Surgical Pathology
- Hospital Epidemiology
Background:
- Suppurative thrombophlebitis is a significant nosocomial infection.
- Intravenous cannulae are frequently used in hospitalized patients.
- Prolonged use of cannulae is a known risk factor for infection.
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of suppurative thrombophlebitis.
- To identify risk factors and associated pathogens.
- To emphasize the importance of timely surgical intervention.
Main Methods:
- Retrospective review of 29 cases of suppurative thrombophlebitis.
- Analysis of patient demographics, cannula dwell time, and implicated microorganisms.
- Correlation of microbial findings with intra-abdominal pathology.
Main Results:
- 27 patients experienced 29 episodes, with 25 involving cannulae in place >3 days.
- Enteric organisms (e.g., Streptococcus faecalis, Pseudomonas aeruginosa) were associated with intra-abdominal pathology (14 patients).
- Staphylococcus aureus and Candida species infections occurred in patients without active abdominal processes (13 patients).
Conclusions:
- Suppurative thrombophlebitis caused by enteric organisms shows a strong association with intra-abdominal pathology.
- This condition is a lethal, preventable infection requiring urgent surgical management.
- Delayed surgical intervention was linked to mortality.