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Cardiology222 papers

Septic thrombophlebitis

Last edited: 4/23/2026

Overview

Septic thrombophlebitis is an inflammatory and thrombotic process involving veins, often secondary to local or systemic infection, with significant potential for systemic complications such as septic emboli 11528.

Diagnosis

  • Clinical signs include localized pain, swelling, erythema, and warmth over the affected vein 326.
  • Imaging modalities like ultrasound are crucial for confirming thrombosis and assessing extent 11183138.
  • Laboratory tests may reveal elevated inflammatory markers (e.g., CRP, ESR) and leukocytosis 626.
  • Specific imaging findings include hypoechoic areas representing thrombus on Doppler ultrasound 1131.
  • Management

  • Antibiotics: Broad-spectrum coverage targeting identified pathogens, adjusted based on culture results 1528.
  • Anticoagulation: Low-molecular-weight heparin (LMWH) for prophylaxis or treatment of associated deep vein thrombosis 3640.
  • Supportive Care: Pain management, elevation, and compression bandages to reduce swelling 2640.
  • Surgical Intervention: Consider for extensive thrombophlebitis, especially involving the saphenofemoral junction 5575.
  • Prophylactic Measures: Use of prophylactic LMWH to prevent extension in high-risk patients 40.
  • Special Populations

  • Pregnancy: Increased risk of thrombophlebitis; careful monitoring and prophylactic measures are essential 2855.
  • Elderly: Higher susceptibility to complications; tailored management considering comorbidities 26.
  • Comorbidities: Patients with history of varicose veins or previous thrombophlebitis require vigilant surveillance 2838.
  • Key Recommendations

  • Initiate broad-spectrum antibiotics promptly targeting likely pathogens based on clinical context (Evidence: Moderate 1528).
  • Consider low-molecular-weight heparin for anticoagulation in patients with associated deep vein thrombosis or high risk of extension (Evidence: Moderate 3640).
  • Use imaging (ultrasound) for accurate diagnosis and monitoring of septic thrombophlebitis extent (Evidence: Moderate 1131).
  • Surgical intervention may be necessary for extensive cases, particularly involving critical veins like the saphenofemoral junction (Evidence: Weak 5575).
  • Implement prophylactic measures in high-risk populations, such as pregnant women and elderly patients, to prevent complications (Evidence: Expert opinion).
  • References

    Showing 100 most recent of 183 indexed papers.

    1 Li S, Xiao H, Liu M, Wang Q, Sun C, Yao J et al.. Network pharmacology and experimental verification to explore the anti-superficial thrombophlebitis mechanism of Mailuo shutong pill. Journal of ethnopharmacology 2024. link 2 Nygren D, Torisson G, Happonen L, Mellhammar L, Linder A, Elf J et al.. Proteomic Characterization of Plasma in Lemierre's Syndrome. Thrombosis and haemostasis 2024. link 3 Xiao J, Xie Y, Liu J, Liu T, Ye R, Duan X et al.. Assessing Mailuoning injection in wound healing and thrombophlebitis management: A rat model study. International wound journal 2024. link 4 Foley MP, Westby D, Walsh SR. A Report of Penile Mondor's Disease After Mechanochemical Ablation and Adjunct Foam Sclerotherapy of Bilateral Lower Extremity Truncal Incompetence. Vascular and endovascular surgery 2023. link 5 Li K, Yu G, Xu Y, Chu H, Zhong Y, Zhan H. Phenotypic and Functional Transformation in Smooth Muscle Cells Derived from a Superficial Thrombophlebitis-affected Vein Wall. Annals of vascular surgery 2022. link 6 Schamroth Pravda M, Yehuda D, Schamroth Pravda N, Krashin E. Risk Factors for Superficial Thrombophlebitis: A Retrospective Case Control Study. The Israel Medical Association journal : IMAJ 2022. link 7 Mielke N, Johnson S, Karabon P, Bahl A. A prospective sonographic evaluation of peripheral intravenous catheter associated thrombophlebitis. The journal of vascular access 2022. link 8 Van Hoecke F, Lamont B, Van Leemput A, Vervaeke S. A Lemierre-like syndrome caused by . Infectious diseases (London, England) 2020. link 9 Heng SY, Yap RT, Tie J, McGrouther DA. Peripheral Vein Thrombophlebitis in the Upper Extremity: A Systematic Review of a Frequent and Important Problem. The American journal of medicine 2020. link 10 Dyadyk OO, Savolyuk SI, Herashchenko RA, Khodos VA, Horbovets VS. Development of obliteration in the great saphenous vein after influence of high-frequency endovenous welding by data of morphological and ultrasonic studies. Wiadomosci lekarskie (Warsaw, Poland : 1960) 2019. link 11 Galyfos G, Kastrisios G, Giannakakis S, Maltezos C. Septic superficial thrombophlebitis in Klippel-Trenaunay syndrome. Acta chirurgica Belgica 2019. link 12 Eso Y, Yoshiji S, Nakakubo Y, Matsuura M, Seno H. Acute Anorectal Thrombophlebitis Caused by a Protein C Deficiency. Internal medicine (Tokyo, Japan) 2018. link 13 Weiss D, Rotman OM, Einav S. Quantitative T2 mapping for detection and quantification of thrombophlebitis in a rabbit model. Journal of biomechanics 2017. link 14 Zerweck C, Knittel M, Zeller T, Schwarz T. Penile Mondor's syndrome after endovenous treatment of the great saphenous vein with 1470 nm diode laser. Phlebology 2015. link 15 Morariu I, Curran A, Killeen RP. Lemierre's syndrome, the forgotten disease. Irish medical journal 2014. link 16 Fraga Veloso G, Fraga Manteiga E, Trehy M, Freeman A, McConnell JF, Dukes McEwan J. Septic pericarditis and myocardial abscess in an English Springer spaniel. Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology 2014. link 17 Majoy SB, Sharp CR, Dickinson AE, Cunningham SM. Septic pericarditis in a cat with pyometra. Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) 2013. link 18 Wu AY, Tseng HK, Su J, Liu CP. Lemierre's syndrome in a patient with habitual toothpick usage. Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 2013. link 19 Davies O, Than M. Lemierre's syndrome: diagnosis in the emergency department. Emergency medicine Australasia : EMA 2012. link 20 Belleflamme M, Penaloza A, Thoma M, Hainaut P, Thys F. Mondor disease: a case report in ED. The American journal of emergency medicine 2012. link 21 Wilmanns C, Casey A, Schinzel H, Walter PK. Superficial thrombophlebitis in varicose vein disease: the particular role of methylenetetrahydrofolate reductase. Phlebology 2011. link 22 Mowry JL, Hartman LS. Intravascular thrombophlebitis related to the peripheral infusion of amiodarone and vancomycin. Western journal of nursing research 2011. link 23 Nakayama M, Tabuchi K, Nomura M, Murashita H, Komeno M, Yamaguchi T et al.. Thrombophlebitis of the head and neck: report of two cases. Auris, nasus, larynx 2010. link 24 Arun Babu T, Sharmila V. Prophylactic topical heparin can prevent or postpone intravenous cannula induced superficial thrombophlebitis. Medical hypotheses 2010. link 25 Bentley TP, Brennan DF. Lemierre's syndrome: methicillin-resistant Staphylococcus aureus (MRSA) finds a new home. The Journal of emergency medicine 2009. link 26 Lee JT, Kalani MA. Treating superficial venous thrombophlebitis. Journal of the National Comprehensive Cancer Network : JNCCN 2008. link 27 Blättler W, Schwarzenbach B, Largiadèr J. Superficial vein thrombophlebitis--serious concern or much ado about little?. VASA. Zeitschrift fur Gefasskrankheiten 2008. link 28 Kupelian AS, Huda MS. Pregnancy, thrombophlebitis and thromboembolism: what every obstetrician should know. Archives of gynecology and obstetrics 2007. link 29 Chiu O, Erbay SH, Bhadelia RA. Lemierre's syndrome revisited: case report and imaging findings. Australasian radiology 2007. link 30 Falagas ME, Vardakas KZ, Athanasiou S. Intravenous heparin in combination with antibiotics for the treatment of deep vein septic thrombophlebitis: a systematic review. European journal of pharmacology 2007. link 31 Dunst KM, Huemer GM, Wayand W, Shamiyeh A. Diffuse phlegmonous phlebitis after endovenous laser treatment of the greater saphenous vein. Journal of vascular surgery 2006. link 32 Singaporewalla RM, Clarke MJ, Krishnan PU, Tan DE. Is this a variant of Lemierre's syndrome?. Singapore medical journal 2006. link 33 Peng MY, Fan CK, Chang FY. Lemierre's syndrome. Journal of the Formosan Medical Association = Taiwan yi zhi 2005. link 34 Jones D, Amsterdam E, Young JN. Septic thrombophlebitis of the coronary sinus with complete recovery after surgical intervention. Cardiology in review 2004. link 35 Costello MF, Drobatz KJ, Aronson LR, King LG. Underlying cause, pathophysiologic abnormalities, and response to treatment in cats with septic peritonitis: 51 cases (1990-2001). Journal of the American Veterinary Medical Association 2004. link 36 Lozano FS, Almazan A. Low-molecular-weight heparin versus saphenofemoral disconnection for the treatment of above-knee greater saphenous thrombophlebitis: a prospective study. Vascular and endovascular surgery 2003. link 37 Peterson PB, Miller MW, Hansen EK, Henry GA. Septic pericarditis, aortic endarteritis, and osteomyelitis in a dog. Journal of the American Animal Hospital Association 2003. link 38 Unno N, Mitsuoka H, Uchiyama T, Yamamoto N, Saito T, Ishimaru K et al.. Superficial thrombophlebitis of the lower limbs in patients with varicose veins. Surgery today 2002. link 39 Pingsmann A, Kröger K, Patsalis T, Voges S, Drebes A. Thrombophlebitis associated with intravenous injection anaesthetics: influence of arm positioning. VASA. Zeitschrift fur Gefasskrankheiten 2002. link 40 Kalodiki E, Nicolaides AN. Superficial thrombophlebitis and low-molecular-weight heparins. Angiology 2002. link 41 Chirinos JA, Lichtstein DM, Garcia J, Tamariz LJ. The evolution of Lemierre syndrome: report of 2 cases and review of the literature. Medicine 2002. link 42 Shetty MK, Watson AB. Mondor's disease of the breast: sonographic and mammographic findings. AJR. American journal of roentgenology 2001. link 43 Raulin S, Raulin C, Greve B. Free-floating thrombus in the femoral vein--a challenge in phlebologic diagnostics. European journal of dermatology : EJD 2001. link 44 De Sanctis MT, Cesarone MR, Incandela L, Belcaro G, Griffin M. Treatment of superficial vein thrombophlebitis of the arm with Essaven gel--a placebo-controlled, randomized study. Angiology 2001. link 45 Jassal DS, Fjeldsted FH, Smith ER, Sharma S. A diagnostic dilemma of fever and back pain postpartum. Chest 2001. link 46 Mayor M, Burón I, de Mora JC, Lázaro TE, Hernández-Cano N, Rubio FA et al.. Mondor's disease. International journal of dermatology 2000. link 47 Gowan RT, Mehran RJ, Cardinal P, Jones G. Thoracic complications of Lemierre syndrome. Canadian respiratory journal 2000. link 48 Tielliu IF, De Maeseneer MG, Tjalma WA, Van Schil PE, Eyskens EJ. Superficial thrombophlebitis of pubic collateral veins after gynecological surgery: a case report. European journal of obstetrics, gynecology, and reproductive biology 1999. link00076-7) 49 Belcaro G, Nicolaides AN, Errichi BM, Cesarone MR, De Sanctis MT, Incandela L et al.. Superficial thrombophlebitis of the legs: a randomized, controlled, follow-up study. Angiology 1999. link 50 Verlato F, Zucchetta P, Prandoni P, Camporese G, Marzola MC, Salmistraro G et al.. An unexpectedly high rate of pulmonary embolism in patients with superficial thrombophlebitis of the thigh. Journal of vascular surgery 1999. link70051-0) 51 Murgia AP, Cisno C, Pansini GC, Manfredini R, Liboni A, Zamboni P. Surgical management of ascending saphenous thrombophlebitis. International angiology : a journal of the International Union of Angiology 1999. link 52 Hanson JN, Ascher E, DePippo P, Lorensen E, Scheinman M, Yorkovich W et al.. Saphenous vein thrombophlebitis (SVT): a deceptively benign disease. Journal of vascular surgery 1998. link70233-2) 53 Brook I. Superficial suppurative thrombophlebitis in children, caused by anaerobic bacteria. Journal of pediatric surgery 1998. link90168-3) 54 Lee BK, Lopez F, Genovese M, Loutit JS. Lemierre's syndrome. Southern medical journal 1997. link 55 Chen CH, Yin CS, Chu TW, Chu TY, Chen WH, Hsiao HS. Extensive thrombophlebitis with reactive thrombocytosis in a high risk Chinese parturient associated with retained placenta increta: a case report. Zhonghua yi xue za zhi = Chinese medical journal; Free China ed 1997. link 56 Andreozzi GM, Signorelli S, Di Pino L, Martini R, Marchitelli E, Pinto A et al.. Tolerability and clinical efficacy of desmin in the treatment of superficial thrombovaricophlebitis. Angiology 1996. link 57 Chang YC, Dai MH, Wang TC, Su CT, Chiu LC. 2-D time-of-flight (TOF) MRA of thrombophlebitis of upper extremity and subclavian veins. A case report. Angiology 1996. link 58 Lundgren A, Wahren LK, Ek AC. Peripheral intravenous lines: time in situ related to complications. Journal of intravenous nursing : the official publication of the Intravenous Nurses Society 1996. link 59 Pusterla N, Braun U. Prophylaxis of intravenous catheter-related thrombophlebitis in cattle. The Veterinary record 1996. link 60 Silverman SG, Hillstrom MM, Doyle CJ, Tempany CM, Sica GT. Thrombophlebitic retroperitoneal collateral veins mimicking lymphadenopathy: MR and CT appearance. Abdominal imaging 1995. link 61 Ascer E, Lorensen E, Pollina RM, Gennaro M. Preliminary results of a nonoperative approach to saphenofemoral junction thrombophlebitis. Journal of vascular surgery 1995. link70049-8) 62 Tighe MJ, Wong C, Martin IG, McMahon MJ. Do heparin, hydrocortisone, and glyceryl trinitrate influence thrombophlebitis during full intravenous nutrition via a peripheral vein?. JPEN. Journal of parenteral and enteral nutrition 1995. link 63 Goyal M, Sharma R, Jain Y, Gupta A, Berry M. Unusual radiological manifestations of Lemierre's syndrome: a case report. Pediatric radiology 1995. link 64 Pusterla N, Braun U. Ultrasonographic evaluation of the jugular vein of cows with catheter-related thrombophlebitis. The Veterinary record 1995. link 65 Villani C, Johnson DH, Cunha BA. Bilateral suppurative thrombophlebitis due to Staphylococcus aureus. Heart & lung : the journal of critical care 1995. link80081-0) 66 Karanas YL, Yim KK, Shuster BA, Lineaweaver WC. Lemierre's syndrome: a case of postanginal septicemia and bilateral flank abscesses. Annals of plastic surgery 1995. link 67 Berrazueta JR, Fleitas M, Salas E, Amado JA, Poveda JJ, Ochoteco A et al.. Local transdermal glyceryl trinitrate has an antiinflammatory action on thrombophlebitis induced by sclerosis of leg varicose veins. Angiology 1994. link 68 Gomez J, Kattamis A, Schenck RC. Pseudothrombophlebitis in an adolescent without rheumatic disease. A case report. Clinical orthopaedics and related research 1994. link 69 Swierzewski SJ, Denil J, Ohl DA. The management of penile Mondor's phlebitis: superficial dorsal penile vein thrombosis. The Journal of urology 1993. link35402-2) 70 Grailhe P, Boyer-Neumann C, Haverkate F, Grimbergen J, Larrieu MJ, Anglés-Cano E. The mutation in fibrinogen Bicêtre II (gamma Asn308-->Lys) does not affect the binding of t-PA and plasminogen to fibrin. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis 1993. link 71 Magee KP, Blanco JD, Graham JM. Massive septic pelvic thrombophlebitis. Obstetrics and gynecology 1993. link 72 Hassen-Khodja R, Gillet JY, Batt M, Bongain A, Persch M, Libo L et al.. Thrombophlebitis of the ovarian vein with free-floating thrombus in the inferior vena cava. Annals of vascular surgery 1993. link 73 Noma M, Ueno Y, Mizushima A, Sese A, Kikuchi Y. Recurrent forearm thrombophlebitis after transvenous permanent pacemaker insertion. Japanese heart journal 1993. link 74 Jorgensen JO, Hanel KC, Morgan AM, Hunt JM. The incidence of deep venous thrombosis in patients with superficial thrombophlebitis of the lower limbs. Journal of vascular surgery 1993. link 75 Lohr JM, McDevitt DT, Lutter KS, Roedersheimer LR, Sampson MG. Operative management of greater saphenous thrombophlebitis involving the saphenofemoral junction. American journal of surgery 1992. link81084-0) 76 Khor T, Anderson J, McRae P. Central venous thrombophlebitis diagnosed by computerized tomography scanning. The Australian and New Zealand journal of surgery 1992. link 77 Teodorescu V, Schanzer H. Management of thrombophlebitis in the prepartum period. A case report. The Journal of cardiovascular surgery 1992. link 78 Yucel EK, Egglin TK, Waltman AC. Extension of saphenous thrombophlebitis into the femoral vein: demonstration by color flow compression sonography. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 1992. link 79 Bachman J. Postpartum ovarian vein thrombophlebitis: etiology, diagnosis, treatment, and nursing implications. Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing 1992. link 80 Lesher JL. Superficial migratory thrombophlebitis. Cutis 1991. link 81 Lutter KS, Kerr TM, Roedersheimer LR, Lohr JM, Sampson MG, Cranley JJ. Superficial thrombophlebitis diagnosed by duplex scanning. Surgery 1991. link 82 McCready RA, Siderys H, Pittman JN, Herod GT, Halbrook HG, Fehrenbacher JW et al.. Septic complications after cardiac catheterization and percutaneous transluminal coronary angioplasty. Journal of vascular surgery 1991. link 83 Gardner SY, Reef VB, Spencer PA. Ultrasonographic evaluation of horses with thrombophlebitis of the jugular vein: 46 cases (1985-1988). Journal of the American Veterinary Medical Association 1991. link 84 Payne-James JJ, Rogers J, Bray MJ, Rana SK, McSwiggan D, Silk DB. Development of thrombophlebitis in peripheral veins with Vialon and PTFE-Teflon cannulas: a double-blind, randomised, controlled trial. Annals of the Royal College of Surgeons of England 1991. link 85 Skillman JJ, Kent KC, Porter DH, Kim D. Simultaneous occurrence of superficial and deep thrombophlebitis in the lower extremity. Journal of vascular surgery 1990. link 86 Samlaska CP, James WD. Superficial thrombophlebitis. II. Secondary hypercoagulable states. Journal of the American Academy of Dermatology 1990. link70179-l) 87 Dickson LR, Badcoe LM, Burbidge H, Kannegieter NJ. Jugular thrombophlebitis resulting from an anaesthetic induction technique in the horse. Equine veterinary journal 1990. link 88 Lugassy G, Klepfish A, Berrebi A. Recurrent thrombophlebitis due to protein C deficiency after splenectomy for immune thrombocytopenic purpura. Acta haematologica 1989. link 89 Johnson JV, Jeske AH, McDaniel HK, Herrera GQ. Development of an in vivo model for assessment of drug-induced vascular injury. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 1989. link80040-0) 90 Subrahmanyam M. Infusion thrombophlebitis--histological and bacteriological study. Indian journal of medical sciences 1989. link 91 Shadowen RD, Trevor RP. Lemierre's postanginal septicemia: internal jugular vein thrombosis related to pharyngeal infection. Southern medical journal 1989. link 92 Haake DA, Hewitt WL, George WL. Suppurative thrombophlebitis due to Aeromonas. Diagnostic microbiology and infectious disease 1988. link90127-7) 93 Hammond JS, Varas R, Ward CG. Suppurative thrombophlebitis: a new look at a continuing problem. Southern medical journal 1988. link 94 Wilensky RL, Nashel DJ. Iliofemoral thrombophlebitis presenting as an acute abdomen: report and literature review. The American journal of the medical sciences 1988. link 95 Green RA, Dowden RV. Mondor's disease in plastic surgery patients. Annals of plastic surgery 1988. link 96 Simionatto CS, Cabal R, Jones RL, Galbraith RA. Thrombophlebitis and disturbed hemostasis following administration of intravenous hematin in normal volunteers. The American journal of medicine 1988. link80092-5) 97 Isada NB, Landy HJ, Larsen JW. Postabortal septic pelvic thrombophlebitis diagnosed with computed tomography. A case report. The Journal of reproductive medicine 1987. link 98 Brown CE, Lowe TW, Cunningham FG, Weinreb JC. Puerperal pelvic thrombophlebitis: impact on diagnosis and treatment using x-ray computed tomography and magnetic resonance imaging. Obstetrics and gynecology 1986. link 99 Castillo M, Murphy B. Septic portal vein thrombophlebitis: computed tomography appearance. Case report. Computerized radiology : official journal of the Computerized Tomography Society 1986. link90033-8) 100 Topiel MS, Bryan RT, Kessler CM, Simon GL. Treatment of silastic catheter-induced central vein septic thrombophlebitis. The American journal of the medical sciences 1986. link

    Original source

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