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Suppurative thrombophlebitis in children: a ten-year experience
E A Khan1, A G Correa, C J Baker
1Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. ekhan@bcm.tmc.edu
The Pediatric Infectious Disease Journal
|January 1, 1997
Summary
Superficial suppurative thrombophlebitis (ST) is a rare, serious nosocomial infection in children. Prompt vein excision and antibiotics are recommended for treatment and to reduce morbidity.
Area of Science:
- Pediatric Infectious Diseases
- Vascular Surgery
- Nosocomial Infections
Background:
- Superficial suppurative thrombophlebitis (ST) is a rare but serious complication in hospitalized children.
- Predisposing factors include underlying medical conditions, invasive procedures, broad-spectrum antibiotics, and total parenteral nutrition.
Purpose of the Study:
- To determine the clinical and diagnostic features of ST in children.
- To investigate complications, management, and prevention strategies for ST in pediatric patients.
Main Methods:
- Retrospective review of medical records for patients diagnosed with phlebitis.
- Study conducted across two urban hospitals over a 10-year period (1985-1995).
Main Results:
- 21 pediatric patients identified with ST, including 12 neonates.
- Common signs included swelling, erythema, induration, and purulent drainage; septicemia occurred in one-third.
- Gram-positive organisms, particularly Staphylococcus aureus, were the predominant pathogens identified in cultures.
Conclusions:
- ST is a significant nosocomial infection in infants and children, leading to considerable morbidity.
- Suspicion is warranted in hospitalized children with fever, localizing signs, or persistent bacteremia, especially those receiving intravenous fluids.
- Recommended treatment involves prompt vein excision combined with antimicrobial therapy to manage ST effectively.